A STUDY TO DETECT THE POSITIVITY RATE OF PEDIATRIC PULMONARY TUBERCULOSIS AND MULTI DRUG RESISTANCE TUBERCULOSIS USING MOLECULAR METHODS
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Keywords
Pediatric Tuberculosis, CBNAAT, Line Probe Assay, Multidrug Resistance, Molecular Diagnosis, Drug-Resistant TB
Abstract
Background: Pediatric tuberculosis (TB) remains a significant public health concern, particularly in high-burden countries like India. Diagnosis is often challenging due to the paucibacillary nature of disease in children and difficulty in obtaining quality sputum samples. Conventional methods lack sensitivity and delay treatment. The advent of molecular diagnostics such as Cartridge-Based Nucleic Acid Amplification Test (CBNAAT) and Line Probe Assay (LPA) offers rapid and accurate detection, including drug resistance.
Objectives: To determine the positivity rate of pulmonary tuberculosis among children under 14 years using CBNAAT.
To detect drug-resistant TB in pediatric patients using CBNAAT.
To assess multidrug resistance (MDR-TB) patterns through first-line and second-line LPA.
Methods: A prospective cross-sectional study was conducted over one year at the Department of Microbiology, KIMS, Hubballi. A total of 865 sputum samples, bronchoalveolar lavage and methods from presumptive pediatric TB cases were analyzed using AFB Sputum microscopy and CBNAAT. Rifampicin resistance detected by CBNAAT was further evaluated using Line Probe Assays for first-line (FL-LPA) and second-line (SL-LPA) anti-TB drugs.
Results: Among the 865 samples, CBNAAT detected Mycobacterium tuberculosis in 136 cases, yielding a positivity rate of 15.7%. Rifampicin resistance was identified in 6 cases (0.7%). FL-LPA confirmed multidrug resistance (RIF and INH) in 7 cases (0.8%), and SL-LPA detected fluoroquinolone resistance in 2 cases (0.2%). Logistic regression showed that children above 8 years had a three-fold higher risk of CBNAAT positivity compared to those ≤8 years.
Conclusion: CBNAAT demonstrated high diagnostic utility for pediatric pulmonary TB with a positivity rate of 15.7%. Molecular methods enabled early detection of drug resistance, vital for guiding appropriate treatment. Incorporating CBNAAT and LPA into routine diagnostic algorithms can enhance TB control among pediatric populations in high-burden settings.
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Dr Rejinold T I
Department of Microbiology, Postgraduate, KMCRI, Hubballi.
Dr Pramod Sambrani
Department of Microbiology, Associate Professor, KMCRI, Hubballi
Dr Rakhi Dixit
Virus Research and Diagnostic Laboratory, Department of Microbiology, Scientist B, KMCRI, Hubballi.
Dr Anubhav sinha
Sinha Department of Microbiology, Postgraduate, KIMS, Hubballi