Diagnosis of pediatric tuberculosis using The Indonesian National Concencus for Pediatric Tuberculosis

Heda Melinda D. Nataprawira; Cissy B. Kartasasmita; Oma Rosmayudi; Hudiyati Agustini

doi:10.14238/pi41.4.2001.185-90

Heda Melinda D. Nataprawira Department of Child Health, Universitas Padjadjaran Medical School/Dr. Hasan Sadikin General Hospital, Bandung, West Java
Cissy B. Kartasasmita Department of Child Health, Universitas Padjadjaran Medical School/Dr. Hasan Sadikin General Hospital, Bandung, West Java
Oma Rosmayudi Department of Child Health, Universitas Padjadjaran Medical School/Dr. Hasan Sadikin General Hospital, Bandung, West Java
Hudiyati Agustini Medical Research Unit, Universitas Padjadjaran Medical School/Dr. Hasan Sadikin General Hospital, Bandung, West Java

DOI: https://doi.org/10.14238/pi41.4.2001.185-90

Keywords: diagnosis, pediatric TB, Indonesian National Consensus

Abstract

Diagnosing tuberculosis (TB) in children correctly is critical to appropriate treatment. However, diagnosing TB in children may be difficult and can be imprecise. As our national TB control program has not adequately covered TB in children and adult TB cases still in high rank, our national consensus for pediatric population may facilitate TB diagnosed especially in the field. ThisÂ cross sectionalÂ study as part ofÂ longitudinalÂ cohort study ofÂ epidemiologyÂ of RespiratoryÂ SyncitialÂ Virus (RSV) in Indonesia (still ongoing) was conducted to know whether criteria used in the algorithm in the consensus compatible to suspected TB diagnosis. The study covered 1000 children under five randomly selected in two districts (Cikutra and Ujung Berung Indah) located in West Java. By usingÂ algorithmÂ of The Indonesian National Consensus For Pediatric Tuberculosis (INCPT) withÂ historyÂ of known or suspected adult source of TB or early reaction of BCG vaccination and certain general clinical symptoms associated TB as entry criteria for a higher index of suspicion, we diagnosed suspected TB in 57 children. We foundÂ that,Â history of known or suspected adult source of TB and certain general clinical symptoms are two main criteria for suspected TB diagnosis. It appeared that Mantoux test gaveÂ a smallestÂ contribution to the diagnosis of suspected TB in the field. No otherÂ criteriumÂ except known or suspected adult source of TB fulfilled for other five children and prophylactic treatment for TB were given. Those children with suspected TB were given oral anti-tuberculosis (OAT) by Directly Observed Treatment Short course (DOTS) done byÂ localÂ trained persons.

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