Diagnostic Tests In Children Research Articles

The serodiagnosis of tuberculosis in children: an evaluation of an ELISA test using IgG antibodies toM. tuberculosis, strain H37 RV

An enzyme-linked immunosorbent assay (ELISA) for detecting serum IgG antibodies to an autoclaved suspension of Mycobacterium tuberculosis H37 RV was evaluated as a diagnostic tool in 132 clinical cases of childhood tuberculosis. The mean (SD) optical density value in these patients was 0.115 (0.122) compared with 0.022 (0.017) in the control group of patients who had non-tuberculous acute respiratory tract infections. Using as a cut-off level the mean of the control plus 2 standard deviations, the test sensitivity was 62% and the specificity was 98% in all the patients with a clinical diagnosis of tuberculosis. In the culture-positive group (n = 35), the sensitivity was 69%. A positive correlation was shown between the optical density levels and increasing age and chronicity of infection but not with respect to tuberculin skin reactivity, nutritional status and the duration of prior therapy. In addition, BCG vaccination (presence of a scar) did not affect the ELISA result. We conclude that this ELISA test is a useful diagnostic test in children.

Diagnostic value of a glass fibre‐based histamine analysis for allergy testing in children

The aim of this study was to compare the diagnostic value of common allergy tests with basophil histamine release in 124 children with symptoms of asthma. The patients were evaluated by case history, skin prick test, RAST-analysis, and basophil histamine release using a glass fibre-based histamine assay to 10 common inhalant allergens. The bronchial provocation test was used as a reference of "true" IgE-mediated asthma. To compare the various diagnostic parameters each absolute test value was classified into a scoring system. The concordance between the tests varied between 85-97%. In general, the best concordance was found between basophil histamine release and RAST. Sensitivity, specificity and predictive values were calculated on the basis of 104 bronchial provocation tests. It was found that histamine release was the best single analysis, followed by RAST and prick testing. The sensitivity of RAST and histamine release was very high (1.00) for pollen and house dust mites. Histamine release showed a predictive value between 0.91 and 1.00 for pollen and house dust mites, thus indicating the possibility of omitting the bronchial provocation test. In the dander group histamine release gave the best sensitivity (0.91), however at the expense of specificity (0.64), whereas RAST and skin prick test gave a specificity of 1.00. In the mould group histamine release also showed the best diagnostic value. The combination of skin testing with histamine release or RAST was of no additional diagnostic help. It is concluded that the glass fibre-based histamine analysis, which makes routine histamine release testing possible, is a reliable diagnostic test in children.

Diagnostic value of the Widal test in childhood typhoid fever.

The usefulness of the Widal test in diagnosing childhood typhoid fever in endemic areas was investigated. The test was done on 150 children with other febrile illnesses and 98 bacteriologically proved cases of typhoid fever. Of the 150 children with nontyphoidal fever, only one had an H agglutinin titer of 1:50. Using an H or O agglutinin titer of 1:50 or more as a criterion for diagnosis, a positive Widal test was found in 88% of typhoid fever cases on the first occasion on which the test was done. If the test was repeated at least 94% of the typhoid cases had a significant result. The Widal test is a useful diagnostic test in children in endemic areas, provided interpretation of the test is made against background information relating to agglutinin levels in normal children in the region.

Serum neuron-specific enolase in children's cancer.

To test its diagnostic potential and sensitivity in paediatric malignancy, serum NSE was measured at diagnosis in 191 children with solid tumours and 25 with acute leukaemia. In stages I + II, III + IV and IVs neuroblastoma median levels were 18.0, 91.0 and 24.0 ng ml-1 respectively. For Wilms' patients, median values for stages I, II, III and IV disease were 16.6, 18.0, 29.0 and 47.0 ng ml-1 respectively. High levels of NSE were also found in patients with other types of tumour. Children in clinical remission after treatment for neuroblastoma invariably had normal NSE levels (mean +/- s.d. = 9.2 +/- 3.0 ng ml-1) even though the majority had radiologically identifiable residual disease. The values rose when relapse was radiologically or clinically obvious. We conclude (a) that, though levels of greater than 100 ng ml-1 are highly suggestive of advanced neuroblastoma, caution should be exercised in using serum NSE as a diagnostic test in children with cancer and (b) that serum NSE levels are not a sensitive index of residual neuroblastoma in patients, with initially elevated levels, that are receiving treatment.

In vivo diagnostic nuclear medicine. Pediatric experience.

The use of radiopharmaceuticals for diagnostic tests in children is increasing and interest in these is evidenced by the addition of scientific sessions devoted to pediatric medicine at annual meetings of The Society of Nuclear Medicine and by the increase in the literature on pediatric dosimetry. Data presented in this paper describe the actual pediatric nuclear medicine experience from 26 nationally representative U.S. hospitals and provide an overview of the pediatric procedures being performed the types of radiopharmaceuticals being used, and the activity levels being administered.

Prevalence and morbidity of Schistosoma haematobium in Egyptian children. A controlled study.

The prevalence and morbidity of schistosomiasis haematobium were studied in three geographically different villages in Giza governorate in Egypt. The survey included 786 children ranging in age from 6 months to 10 years. There was a marked variation in the prevalence of infection in the three areas, correlated with the socioeconomic standards and sanitary habits, emphasizing their role in the spread of the disease. The youngest child infected was a 14-month-old boy, while the peak of prevalence of infection was in children 8 to 10 years old. The intensity of infection, as indicated by the heaviness of urinary egg output (mean of 3 successive days), was unrelated to the degree of prevalence in the area concerned. On the other hand, such intensity of infection correlated well with the severity of the clinical picture. Immediate skin-test reactivity was related to the intensity of infection, though unreliable as a single diagnostic test in children. Delayed reactivity was less sensitive. Stool examination showed a higher prevalence of other helminthic infections in schistosome-infected children aged 6 to 10 years than in uninfected children. The impact of schistosomiasis on the general health of children as shown by the anthropometric measurements was mild, except in heavily infected children in whom it was significant. The study focused on the overshadowed young age period when infection can be radically cured and even easily avoided. The data point to the importance of considering the intensity of infection, and not the prevalence, in weighing the need for therapy against its toxic effects in children, or in discussing the priorities of treatment in an endemic area.

Reviews, etc.: A Diagnostic Test for Children and Adolescents.

Reviews, etc.: A Diagnostic Test for Children and Adolescents.