Revista do Instituto de Medicina Tropical de São Paulo (Oct 2020)

Diagnosis of pulmonary tuberculosis in children and adolescents: comparison of two versions of the Brazilian Ministry of Health scoring system

  • Roberta Feijó Carvalho,
  • Anna Cristina Calçada Carvalho,
  • Luis Guillermo Coca Velarde,
  • Andrea Maciel de Oliveira Rossoni,
  • Rafaela Baroni Aurilio,
  • Selma Maria de Azevedo Sias,
  • Christiane Mello Schmidt,
  • Adriana da Silva Rezende Moreira,
  • Pedro da Silva Martins,
  • Lorrayne Isidoro Gonçalves,
  • Terezinha Miceli Martire,
  • Ana Paula Ferreira Barbosa,
  • Ana Paula Quintanilha dos Santos,
  • Roberta Maia de Castro Romanelli,
  • Maria das Graças Rodrigues de Oliveira,
  • Lilian Martins Oliveira Diniz,
  • Andrea Lucchesi de Carvalho,
  • Sheila Cunha Lucena,
  • Maria Letícia Santos Cruz,
  • Mariza Curto Saavedra,
  • Tony Tannous Tahan,
  • Cristina de Oliveira Rodrigues,
  • Afrânio Lineu Kritski,
  • Clemax Couto Sant’Anna,
  • Claudete Aparecida Araújo Cardoso,
  • Maria de Fátima Bazhuni Pombo Sant’Anna

DOI
https://doi.org/10.1590/s1678-9946202062081
Journal volume & issue
Vol. 62

Abstract

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ABSTRACT The aim of this study was to evaluate the concordance between two versions of the scoring system (2011 and 2019), recommended by the Brazilian Ministry of Health, for the diagnosis of pulmonary tuberculosis (PTB) in children and adolescents. A retrospective descriptive study was performed to assess the medical records of children and adolescents with PTB, in TB units from Brazilian cities located in Rio de Janeiro, Minas Gerais, and Parana States, from January 1 st , 2004, to December 1 st , 2018. Patients aged 0 to 18 years old with a diagnosis of PTB were included. The comparison between the two scoring systems showed a moderate concordance according to the κ coefficient value = 0.625. Fourteen patients showed a reduction in the TB score, going from 30 points in the 2011, to 25 points or less in the 2019 one. Seventy one percent of these 14 patients had radiological changes suggestive of PTB and 86% had tuberculin skin tests greater than 10 mm. The study concluded that a moderate agreement was observed between the 2011 and 2019 scoring systems, with an increase in the number of patients scoring 25 points or less in 2019, which can eventually hinder the diagnosis of PTB.

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