Abstract
Background: Tuberculosis which is caused by Mycobacterium tuberculosis a chronic infectious disease is considered the second most common infectious cause of mortality and morbidity in children around the world. This study was carried out to test the validity of Crofton, Horne and Miller scoring system for the diagnosis of children suffering from tuberculosis.
 Materials and Methods: It was done in an inpatient ward of a pediatric tertiary referral centre, from Feb 2018 to Jan 2019as a prospective case control study, including 92 children aged 2 years to 12 years admitted with clinical differential diagnosis of tuberculosis. Among them 46 children meeting the case definition were taken as cases and 46 were age, sex and disease presentation matched controls.
 Results: Sensitivity of the score was low (50%) but the specificity was high (95%) with 92% positive predictive value and a negative predictive value of 65.67%. Contact with an adult suffering from tuberculosis, positive Mantoux test (>10mm in duration) were found to be the most important indicators of TB in children. Males were found to be affected twice as much as the females.
 Conclusion: From the findings of the study, it can be concluded that the Crofton, Horne, Miller score chart is a simple and cost-effective tool, which can be applied to improve the diagnosis of TB in children due to financial constraints faced by patients in resource limited countries like Nepal.
Highlights
IntroductionTuberculosis (TB) is a chronic infectious disease caused by organisms of the Mycobacterium tuberculosis (M tb) complex, which includes M tb, M bovis, M africanum, M chelonei, M fortiutum, M microtii etc
From the findings of the study, it can be concluded that the Crofton, Horne, Miller score chart is a simple and cost-effective tool, which can be applied to improve the diagnosis of TB in children due to financial constraints faced by patients in resource limited countries like Nepal
Tuberculosis (TB) is a chronic infectious disease caused by organisms of the Mycobacterium tuberculosis (M tb) complex, which includes M tb, M bovis, M africanum, M chelonei, M fortiutum, M microtii etc
Summary
Tuberculosis (TB) is a chronic infectious disease caused by organisms of the Mycobacterium tuberculosis (M tb) complex, which includes M tb, M bovis, M africanum, M chelonei, M fortiutum, M microtii etc. In any child, who cannot effectively expectorate sputum or if the cough is absent or nonproductive, the best specimen for diagnosis of pulmonary TB is an early-morning aspiration of gastric contents which even under ideal circumstances, range from 28 to 40%, rates can go up to 75% in infants [5]. To enable more accurate diagnosis of tuberculosis in children especially in low-income countries, various clinical, epidemiological and laboratory parameters have been used to devise effective, simple and reliable tests [6]. Mycobacterium tuberculosis a chronic infectious disease, is considered the second most common infectious cause of mortality and morbidity in children around the world. This study was carried out to test the validity of Crofton, Horne and Miller scoring system for the diagnosis of children suffering from tuberculosis
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