Diagnostic accuracy of Modified Kenneth Jones Scoring Criteria (MKJSC) in confirmed cases of Tuberculosis in children

Abstract

Abstract

Background:  Tuberculosis (TB) is a granulomatous disease caused by Mycobacterium tuberculosis. The gold standard for the diagnosis of tuberculosis is dete-ction of Mycobacterium tubercle bacilli. However, cli-nical scoring systems are most widely used for the dia-gnosis of TB in children.

Objective:  To determine the diagnostic accuracy of modified Kenneth Jones scoring criteria (MKJSC) in conformed cases of tuberculosis.

Methodology:  This cross-sectional comparative study was conducted in the department of Paediatrics, King Edward Medical University / Mayo Hospital, Lahore from January to June 2007. One hundred children below 15 years of age were enrolled. They were diag-nosed as suspected cases of TB on the basis of fever and cough for more than 15 days. MKJSC was applied and each child was subjected to confirmatory test for TB.

Results:  There was an overall male preponderance of 54%. The mean age of study population was 1.8 ± 0.7 years. Out of 100 children, 66% were diagnosed as TB cases (23 with confirmatory tests and 43 with MKJSC of 5 or more). Sensitivity, specificity, positive and negative predictive value of MKJSC was 73.91%, 44.16%, 28.33%, and 85% respectively. Diagnostic accuracy of MKJSC was 51%.

Conclusion:  Present study does not support the hypo-thesis that MKJSC is a good alternative to confirma-tory tests to diagnose tuberculosis in children. How-ever, MKJSC is a simple tool, which can be applied to improve the case detection rate in the absence of soph-isticated tests.

Key words:  BCG vaccination, Children, Diagnosis, Modified Kenneth Jones scoring criteria, MKJSC, Tuberculosis.