Background To confirming diagnosis tuberculosis (TB) in children is still challenging worldwide, particularly in low-resource settings. The Microscopic Observation Drug Susceptibility (MODS) is promising whilst this assay improved yield recovery of Mycobacterium tuberculosis that is faster and better as compared with traditional culture method. In Indonesia, MODS culture study in adults TB have been reported but not for childhood TB because of the cost.
Methods Gastric aspirate specimen were collected from 10 children aged ≤14 years suspected has having severe TB admitted to paediatric ward Hasan Sadikin Hospital-Bandung-Indonesia in 2011 examined by acid-fast bacilli (AFB) and cultured by MODS in Department of Clinical Pathology. We presumed TB for those children who responded clinically at the end of their TB treatment. The outcome measurements were proportion of specimens that culture positive by MODS.
Results Eight of 10 children were preadolescents and adolescents age. All children were severe malnourished, but one. Tuberculous meningitis was diagnosed in 3/10 children and others seven children diagnosed as spondylitis TB (1), destroyed lung TB (1), cutaneous TB (1), extensive pneumonic TB (4). All had positive AFB, but two. MODS provided significantly more positive cultures (8/10) and occurred in positive AFB children. Eight children were on directly-observed treatment shortcourse (DOTS).
Conclusion Isolation of Mycobacterium tuberculosis from severe TB children demonstrated greater yield by MODS culture assay and more frequent in preadolescent and adolescents children.
- MODS culture
- Severe TB