Feasibility of the string test for tuberculosis diagnosis in children between 4 and 14 years old
Abstract Background The enteric string test can be used to obtain a specimen for microbiological confirmation of tuberculosis in children, but it is not widely used for this. The aim of this analysis to evaluate this approach in children with tuberculosis symptoms. Methods We conducted a cross-secti...
| Main Authors: | , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2018-11-01
|
| Series: | BMC Infectious Diseases |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12879-018-3483-0 |
| _version_ | 1818030090583277568 |
|---|---|
| author | Karla T. Tafur Julia Coit Segundo R. Leon Cynthia Pinedo Silvia S. Chiang Carmen Contreras Roger Calderon Milagros J. Mendoza Leonid Lecca Molly F. Franke |
| author_facet | Karla T. Tafur Julia Coit Segundo R. Leon Cynthia Pinedo Silvia S. Chiang Carmen Contreras Roger Calderon Milagros J. Mendoza Leonid Lecca Molly F. Franke |
| author_sort | Karla T. Tafur |
| collection | DOAJ |
| description | Abstract Background The enteric string test can be used to obtain a specimen for microbiological confirmation of tuberculosis in children, but it is not widely used for this. The aim of this analysis to evaluate this approach in children with tuberculosis symptoms. Methods We conducted a cross-sectional study to assess children’s ability to complete the test (feasibility), and self-reported pain (tolerability). We examined caregivers’ and children’s willingness to repeat the procedure (acceptability) and described the diagnostic yield of cultures for diagnostic tools. We stratified estimates by age and compared metrics to those derived for gastric aspirate (GA). Results Among 148 children who attempted the string test, 34% successfully swallowed the capsule. Feasibility was higher among children aged 11–14 than in children 4–10 years (83% vs 22% respectively, p < 0.0001). The string test was better tolerated than GA in both age groups; however, guardians and older children reported higher rates of willingness to repeat GA than the string test (86% vs. 58% in children; 100% vs. 83% in guardians). In 9 children with a positive sputum culture, 6 had a positive string culture. The one children with a positive gastric aspirate culture also had a positive string culture. Conclusion Although the string test was generally tolerable and accepted by children and caregivers; feasibility in young children was low. Reducing the capsule size may improve test success rates in younger children. |
| first_indexed | 2024-12-10T05:30:03Z |
| format | Article |
| id | doaj.art-884091c6b94f49aa8fdee633832bbea8 |
| institution | Directory Open Access Journal |
| issn | 1471-2334 |
| language | English |
| last_indexed | 2024-12-10T05:30:03Z |
| publishDate | 2018-11-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Infectious Diseases |
| spelling | doaj.art-884091c6b94f49aa8fdee633832bbea82022-12-22T02:00:34ZengBMCBMC Infectious Diseases1471-23342018-11-011811810.1186/s12879-018-3483-0Feasibility of the string test for tuberculosis diagnosis in children between 4 and 14 years oldKarla T. Tafur0Julia Coit1Segundo R. Leon2Cynthia Pinedo3Silvia S. Chiang4Carmen Contreras5Roger Calderon6Milagros J. Mendoza7Leonid Lecca8Molly F. Franke9Socios En Salud Sucursal PerúDepartment of Global Health and Social Medicine, Harvard Medical SchoolDepartment of Global Health and Social Medicine, Harvard Medical SchoolSocios En Salud Sucursal PerúDepartment of Pediatrics, Alpert Medical School of Brown UniversitySocios En Salud Sucursal PerúSocios En Salud Sucursal PerúSocios En Salud Sucursal PerúSocios En Salud Sucursal PerúDepartment of Global Health and Social Medicine, Harvard Medical SchoolAbstract Background The enteric string test can be used to obtain a specimen for microbiological confirmation of tuberculosis in children, but it is not widely used for this. The aim of this analysis to evaluate this approach in children with tuberculosis symptoms. Methods We conducted a cross-sectional study to assess children’s ability to complete the test (feasibility), and self-reported pain (tolerability). We examined caregivers’ and children’s willingness to repeat the procedure (acceptability) and described the diagnostic yield of cultures for diagnostic tools. We stratified estimates by age and compared metrics to those derived for gastric aspirate (GA). Results Among 148 children who attempted the string test, 34% successfully swallowed the capsule. Feasibility was higher among children aged 11–14 than in children 4–10 years (83% vs 22% respectively, p < 0.0001). The string test was better tolerated than GA in both age groups; however, guardians and older children reported higher rates of willingness to repeat GA than the string test (86% vs. 58% in children; 100% vs. 83% in guardians). In 9 children with a positive sputum culture, 6 had a positive string culture. The one children with a positive gastric aspirate culture also had a positive string culture. Conclusion Although the string test was generally tolerable and accepted by children and caregivers; feasibility in young children was low. Reducing the capsule size may improve test success rates in younger children.http://link.springer.com/article/10.1186/s12879-018-3483-0PediatricPeruTolerabilityFeasibilityGastric aspirate |
| spellingShingle | Karla T. Tafur Julia Coit Segundo R. Leon Cynthia Pinedo Silvia S. Chiang Carmen Contreras Roger Calderon Milagros J. Mendoza Leonid Lecca Molly F. Franke Feasibility of the string test for tuberculosis diagnosis in children between 4 and 14 years old BMC Infectious Diseases Pediatric Peru Tolerability Feasibility Gastric aspirate |
| title | Feasibility of the string test for tuberculosis diagnosis in children between 4 and 14 years old |
| title_full | Feasibility of the string test for tuberculosis diagnosis in children between 4 and 14 years old |
| title_fullStr | Feasibility of the string test for tuberculosis diagnosis in children between 4 and 14 years old |
| title_full_unstemmed | Feasibility of the string test for tuberculosis diagnosis in children between 4 and 14 years old |
| title_short | Feasibility of the string test for tuberculosis diagnosis in children between 4 and 14 years old |
| title_sort | feasibility of the string test for tuberculosis diagnosis in children between 4 and 14 years old |
| topic | Pediatric Peru Tolerability Feasibility Gastric aspirate |
| url | http://link.springer.com/article/10.1186/s12879-018-3483-0 |
| work_keys_str_mv | AT karlattafur feasibilityofthestringtestfortuberculosisdiagnosisinchildrenbetween4and14yearsold AT juliacoit feasibilityofthestringtestfortuberculosisdiagnosisinchildrenbetween4and14yearsold AT segundorleon feasibilityofthestringtestfortuberculosisdiagnosisinchildrenbetween4and14yearsold AT cynthiapinedo feasibilityofthestringtestfortuberculosisdiagnosisinchildrenbetween4and14yearsold AT silviaschiang feasibilityofthestringtestfortuberculosisdiagnosisinchildrenbetween4and14yearsold AT carmencontreras feasibilityofthestringtestfortuberculosisdiagnosisinchildrenbetween4and14yearsold AT rogercalderon feasibilityofthestringtestfortuberculosisdiagnosisinchildrenbetween4and14yearsold AT milagrosjmendoza feasibilityofthestringtestfortuberculosisdiagnosisinchildrenbetween4and14yearsold AT leonidlecca feasibilityofthestringtestfortuberculosisdiagnosisinchildrenbetween4and14yearsold AT mollyffranke feasibilityofthestringtestfortuberculosisdiagnosisinchildrenbetween4and14yearsold |