TY - GEN T1 - Laboratory diagnosis of paediatric tuberculosis in the European Union/European Economic Area: analysis of routine laboratory data, 2007 to 2011 AU - Sanchini, Andrea AU - Fiebig, L AU - Drobniewski, F. AU - Haas, Walter AU - Richter, Elvira AU - Katalinic-Jankovic, V. AU - Pimkina, E. AU - Skenders, G. AU - Cirillo, D. M. AU - Balabanova, Yanina AB - Laboratory confirmation of paediatric tuberculosis (TB) is frequently lacking. We reviewed the range of routine laboratory tests and their performance in different biological samples used to diagnose active TB in children. A questionnaire-based survey was conducted among the European Reference Laboratory Network for TB followed by collection of routine laboratory data on 10,549 paediatric samples tested in 2007 to 2011 at six reference laboratories (in Croatia, Germany, Italy, Latvia, Lithuania and the United Kingdom (UK)). The questionnaire showed that all laboratories used rapid assays. Non-respiratory samples were collected more often in Germany (135/275, 49.1%) and the UK (490/2,140, 22.9%) compared with Croatia (138/2,792, 4.9%), Latvia (222/2,401, 9.2%) and Lithuania (76/1,549, 4.9%). Overall laboratory positivity rates (isolation of Mycobacterium tuberculosis complex and/or identification of its nucleic acids in a sample) were higher in lymph node and gastric aspirate samples (14/203 (6.9%) and 43/1,231 (3.5%)) than in sputum samples (89/4,684 (1.9%)). Pooled sensitivity, specificity, positive and negative predictive values and accuracy of molecular assays assessed against solid or liquid culture were 79.2%, 93.6%, 67.1%, 96.5% and 91.6%, respectively. A more intensive approach in obtaining gastric aspirate and non-respiratory samples may increase laboratory confirmation of paediatric TB. Major effort is needed in optimisation and validation of molecular tests in these samples. KW - Humans KW - Algorithms KW - Europe KW - Child KW - Sensitivity and Specificity KW - Retrospective Studies KW - Mycobacterium tuberculosis/isolation & purification KW - Questionnaires KW - Clinical Laboratory Techniques/methods KW - European Union KW - Laboratories KW - Sputum/microbiology KW - Tuberculin Test/methods KW - Tuberculosis/diagnosis KW - Tuberculosis/microbiology KW - 610 Medizin PY - 2014 LA - eng PB - Robert Koch-Institut, Infektionsepidemiologie VL - 19 IS - 11 DO - http://dx.doi.org/10.25646/1776 ER -