Publications - Journal

Pakistan Pediatric Association’s Scoring Chart for Diagnosis of Tuberculosis in Children

Volumn 35, Issue 2 - June 01, 2011

Objectives
To validate the applicability of Pakistan Paediatric association’s (PPA) Scoring chart to diagnose tuberculosis in children.

Method

In this prospective descriptive study, 200 children aged 6 months to 16 years who fulfilled the inclusion criteria were enrolled and evaluated with PPA scoring chart. Antituberculous therapy (ATT) was started in all patients having score > 7 and in those patients having score less than 7 but who had strong clinical suspicion of tuberculosis. Antituberculous therapy was given for a period of 8 – 9 months and these patients were followed monthly for same duration.

 
Results

Among a total of 200 children, 123 (61.5%) were diagnosed as having tuberculosis. Out of these 123, 56 (45.5%) were male and 67 (54.5%) were female.Pulmonary tuberculosis was observed in 84 (68%). Extra-pulmonary tuberculosis was observed in 32% of the patients. BCG scar was present in 45 (37%). There were 8 children who had measles or whooping cough. Five children were immunocompromised and 16 patients were of protein calorie malnutrition (PCM) grade III. In 99 (80.5%) patients physical examination was suggestive of tuberculosis and 24 (19.5%) had signs/symptoms strongly suggestive of tuberculosis. Nonspecific radiological findings were present in 56 (45.5%) while 35 (28.5%) patients had specific radiological findings. Tuberculin test more than 10 mm was present in 30 (24%) children while 43 (35%) patients had induration between 5 – 10 mm. Granuloma specific to TB was positive in 16 (13%) children.

 
Conclusion
This study implies that simple screening tools like PPA scoring chart has a definite value in identifying childhood tuberculosis in tuberculous endemic countries with limited resources.
 
Key words

Tuberculosis. Tuberculin skin test. Pakistan Pediatric Association Scoring Chart.