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Carvalho RF, Carvalho ACC, Velarde LGC, Rossoni AMDO, Aurilio RB, Sias SMDA, Schmidt CM, Moreira ADSR, Martins PDS, Gonçalves LI, Martire TM, Barbosa APF, Santos APQD, Romanelli RMDC, Oliveira MDGRD, Diniz LMO, Carvalho ALD, Lucena SC, Cruz MLS, Saavedra MC, Tahan TT, Rodrigues CDO, Kritski AL, Sant'Anna CC, Cardoso CAA, Sant'Anna MDFBP. Diagnosis of pulmonary tuberculosis in children and adolescents: comparison of two versions of the Brazilian Ministry of Health scoring system. Rev Inst Med Trop Sao Paulo 2020; 62:e81. [PMID: 33146310 PMCID: PMC7608063 DOI: 10.1590/s1678-9946202062081] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 10/01/2020] [Indexed: 11/22/2022] Open
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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Affiliation(s)
| | | | | | | | | | | | | | | | - Pedro da Silva Martins
- Instituto Oswaldo Cruz , Fundação Oswaldo Cruz , Rio de Janeiro , Rio de Janeiro , Brazil
| | | | | | | | | | | | | | | | | | - Sheila Cunha Lucena
- Hospital Municipal Raphael de Paula Souza , Rio de Janeiro , Rio de Janeiro , Brazil
| | | | - Mariza Curto Saavedra
- Hospital Federal dos Servidores do Estado , Rio de Janeiro , Rio de Janeiro , Brazil
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