Diagnostic accuracy of microscopic Observation Drug Susceptibility (MODS) assay for pediatric tuberculosis in Hanoi, Vietnam

Microscopic [corrected] Observation Drug Susceptibility (MODS) has been shown to be an effective and rapid technique for early diagnosis of tuberculosis (TB). Thus far only a limited number of studies evaluating MODS have been performed in children and in extra-pulmonary tuberculosis. This study aim...

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Bibliographic Details
Published in:PloS one 2013-09, Vol.8 (9), p.e72100-e72100
Main Authors: Tran, Sinh Thi, Renschler, John Patrick, Le, Hai Thanh, Dang, Hang Thi Thu, Dao, Tuan Minh, Pham, An Nhat, Nguyen, Liem Thanh, Van Nguyen, Hung, Thi Thu Nguyen, Thuy, Ngoc Le, Sy, Fox, Annette, Caws, Maxine, Thi Quynh Nguyen, Nhu, Thi Quynh, Nhudo, Horby, Peter, Wertheim, Heiman
Format: Article
Language:English
Subjects:
Accuracy
Agar
Analysis
Child, Preschool
Children
Children's hospitals
Clinical medicine
Culture
Diagnosis
Diagnostic systems
Diagnostic Tests, Routine - economics
Diagnostic Tests, Routine - methods
Female
Hospitals
Humans
Infant
Infectious diseases
Laboratories
Male
Malnutrition
Medical diagnosis
Medicine
Mortality
Mycobacterium tuberculosis
Pediatrics
Pleural fluid
Sensitivity
Sensitivity analysis
Sensitivity and Specificity
Smear
Sputum
Survival analysis
Tuberculosis
Tuberculosis - diagnosis
Tuberculosis, Multidrug-Resistant - diagnosis
Vietnam
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Summary:Microscopic [corrected] Observation Drug Susceptibility (MODS) has been shown to be an effective and rapid technique for early diagnosis of tuberculosis (TB). Thus far only a limited number of studies evaluating MODS have been performed in children and in extra-pulmonary tuberculosis. This study aims to assess relative accuracy and time to positive culture of MODS for TB diagnosis in children admitted to a general pediatric hospital in Vietnam. Specimens from children with suspected TB were tested by smear, MODS and Lowenstein-Jensen agar (LJ). 1129 samples from 705 children were analyzed, including sputum (n=59), gastric aspirate (n=775), CSF (n=148), pleural fluid (n=33), BAL (n=41), tracheal fluid (n=45), other (n=28). 113 TB cases were defined based on the "clinical diagnosis" (confirmed and probable groups) as the reference standard, in which 26% (n=30) were diagnosed as extra-pulmonary TB. Analysis by patient shows that the overall sensitivity and specificity of smear, LJ and MODS against "clinical diagnosis" was 8.8% and 100%, 38.9% and 100%, 46% and 99.5% respectively with MODS significantly more sensitive than LJ culture (P=0.02). When analyzed by sample type, the sensitivity of MODS was significantly higher than LJ for gastric aspirates (P=0.004). The time to detection was also significantly shorter for MODS than LJ (7 days versus 32 days, P
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0072100