期刊
JOURNAL OF THE PEDIATRIC INFECTIOUS DISEASES SOCIETY
卷 11, 期 7, 页码 316-321出版社
OXFORD UNIV PRESS
DOI: 10.1093/jpids/piac015
关键词
C-reactive protein; child; tuberculosis; triage
资金
- National Heart, Lung, and Blood Institute [R01HL139717, K23HL153581]
- National Institute of Child Health and Human Development [K12HD000850]
In a study conducted in Kampala, Uganda, C-reactive protein levels were found to be low in children with respiratory symptoms, and did not meet the accuracy requirements for a triage test for pulmonary tuberculosis, regardless of TB status.
In a prospective cohort of children with respiratory symptoms in Kampala, Uganda, C-reactive protein levels were low regardless of tuberculosis status and did not achieve the target accuracy for a triage test for pulmonary tuberculosis. Background C-reactive protein (CRP) has shown promise as a triage tool for pulmonary tuberculosis (TB) in adults living with the human immunodeficiency virus. We performed the first assessment of CRP for TB triage in children. Methods Symptomatic children less than 15 years old were prospectively enrolled in Kampala, Uganda. We completed a standard TB evaluation and measured CRP using a point-of-care assay. We determined the sensitivity and specificity of CRP to identify pulmonary TB in children using 10 mg/L and 5 mg/L cut-off points and generated a receiver operating characteristic (ROC) curve to determine alternative cut-offs that could approach the target accuracy for a triage test (>= 90% sensitivity and >= 70% specificity). Results We included 332 children (median age 3 years old, interquartile range [IQR]: 1-6). The median CRP level was low at 3.0 mg/L (IQR: 2.5-26.6) but was higher in children with Confirmed TB than in children with Unlikely TB (9.5 mg/L vs. 2.9 mg/L, P-value = .03). At a 10 mg/L cut-off, CRP sensitivity was 50.0% (95% confidence interval [CI], 37.0-63.0) among Confirmed TB cases and specificity was 63.3% (95% CI, 54.7-71.3) among children with Unlikely TB. Sensitivity increased to 56.5% (95% CI, 43.3-69.0) at the 5 mg/L cut-off, but specificity decreased to 54.0% (95% CI, 45.3-62.4). The area under the ROC curve was 0.59 (95% CI, 0.51-0.67), and the highest sensitivity achieved was 66.1% at a specificity of 46.8%. Conclusions CRP levels were low in children with pulmonary TB, and CRP was unable to achieve the accuracy targets for a TB triage test.
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据