|
|
This is only a preview of the paper
Click here to register and get the full text.
Existing members click here to login
|
|
|
Original ArticleKeith Edwards Score for Diagnosis of TuberculosisShyam Narayan, S. Mahadevan and V. Tiroumourougane SeraneDepartment of Pediatrics, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India. Abstract. Objective : To evaluate the applicability of Keith Edwards scoring system for the diagnosis of childhood tuberculosis. Methods. One hundred and one children aged 2 months to 12 years who fulfilled the inclusion criteria were evaluated with Keith Edwards score. The diagnosis of tuberculosis by Keith Edwards score and the definitive reference were compared. Results. Among the 65 children diagnosed as having tuberculosis by the definitive reference, 59 had a Keith Edwards score of >7. Four children had a score of >7 but were not suffering from tuberculosis. The sensitivity and specificity of this score have been found to be 91% and 88% respectively. Conclusion. In select population with indicative clinical features, Keith Edwards score can be a definitive guideline for the diagnosis of childhood tuberculosis. However, more studies are required for the validation of this clinical score before it can be used as a definitive diagnostic reference standard for tuberculosis. [Indian J Pediatr 2003; 70 (6) : 467-469] Childhood Tuberculosis is a widespread disease with nonspecific clinical manifestations and is often underdiagnosed even in the high-risk pediatric population. Recovery of tubercle bacilli, which establishes the diagnosis with certainty, is difficult in children. Tests for an early diagnosis based on immunological and molecular methods are not always available for routine use in low-income countries. In order to make the diagnosis of tuberculosis easy without the aid of sophisticated investigations, various scoring systems have been described for use in children.1,2,3,4 One such clinical score devised by Keith Edwards5 is especially relevant to resource poor countries, but its usefulness has not been widely studied. Hence, the present study was performed to evaluate the applicability of Keith Edwards scoring system for the diagnosis of childhood tuberculosis (Table 1).MATERIALS AND METHODSThis study was conducted in Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER). Pondicherry from March 2000 to March 2001. All children between 2 months and 12 years who were admitted in the department of Pediatrics were screened for the presence of certain indicative clinical features (inclusion criteria) and those who satisfied these criteria were recruited into the study. The inclusion criteria were unexplained fever lasting for ¡Ý 7 days with any one of the following features ¨C (a) malnutrition and loss of playful activity, (b) unexplained abdominal mass or ascites, (c) coma, convulsions, partial seizures or focal neurological deficit and (d) significant lymph nodes.
Approximate Word count = 1506
Approximate Pages = 6
(250 words per page double spaced)
|
|
|
|
|
|