Abstract
Introduction and Aim:Childhood tuberculosis (TB) remains a major problem worldwide.However, diagnosis of tuberculosis in children is often complicated by the difficulty in obtaining a proper sputum specimens and low sensitivity of the gold standard diagnostic test to confirm the presence of Mycobacterium tuberculosis(M.tb)in this age group. Recently, M.tbantigen detection in urinaryspecimenshas become a popular method. It is non-invasiveand handling of specimen is simple. It was reported that urinary CFP-10, a specific protein of M.tb, has emerged as a potential biomarker in the future. However, its diagnostic value as a new biomarker in childhood TB remains poorly understood.The aim of the study is to determine the diagnostic value of urinary CFP-10 in childhood TB.
 
 Methods: Seventy children with suspected pulmonary or extrapulmonary TB were enrolled. Tuberculosis was diagnosed by performingTuberculin skin test, chest x-ray, microscopic examination, and microbiological cultureobtainedfrom sputum or gastric lavage specimen. The level ofurinary CFP-10 antigen was analyzedbyELISA (Elabscience, China). Statistical analyseswereperformed using SPSS 21.0 and p-values of <0.05 were consideredstatistically significant.
 
 Results: The levels of urinary CFP-10 in subjects diagnosed with TB was higher than that of the non-TB subjects, 4.13(0.62) vs 0.43(0.14) pg/mL, p=0.005. The cut-off value forurinary CFP-10 level reached 0.39 pg/mL (sensitivity 65% and specificity 67%). This value became0.54 pg/mL (sensitivity 61% and specificity 62%)in microbiologically confirmed cases.
 
 Conclusion: The urinary CFP-10 level has moderate diagnostic value for diagnosing childhood TB.
 
Highlights
Introduction and AimChildhood tuberculosis (TB) remains a major problem worldwide
The level of urinary Culture filtrate protein10 (CFP-10) antigen was analyzed by enzyme-linked immunosorbent assay (ELISA) (Elabscience, China)
The levels of urinary CFP-10 in subjects diagnosed with TB was higher than that of the non-TB subjects, 4.13(0.62) vs 0.43(0.14) pg/mL, p=0.005
Summary
Diagnosis of tuberculosis in children is often complicated by the difficulty in obtaining a proper sputum specimens and low sensitivity of the gold standard diagnostic test to confirm the presence of Mycobacterium tuberculosis (M.tb) in this age group. M.tb antigen detection in urinary specimens has become a popular method. According to World Health Organization (WHO) estimates, an estimated million people developed TB in 2017 Of this number, an estimated 1 million children became ill with TB[1,2,3]. Diagnosis of pulmonary TB in children is extremely challenging Clinical symptoms, such as chronic cough or growth failure, are nonspecific [4,5,6]. In many cases of childhood TB, diagnosis is often based on contact history with adult TB patients, clinical symptoms and signs, TST, as well as chest x-ray interpretations(1113)
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