[Source: Eurosurveillance, full page: (LINK). Abstract, edited.]

Eurosurveillance, Volume 19, Issue 11, 20 March 2014 / Research articles

Laboratory diagnosis of paediatric tuberculosis in the European Union/European Economic Area: analysis of routine laboratory data, 2007 to 2011

A Sanchini <SUP>1</SUP><SUP>,2</SUP>, L Fiebig<SUP>2</SUP>, F Drobniewski<SUP>3</SUP><SUP>,4</SUP>, W Haas<SUP>1</SUP>, E Richter<SUP>5</SUP>, V Katalinic-Jankovic<SUP>6</SUP>, E Pimkina<SUP>7</SUP>, G Skenders<SUP>8</SUP>, D M Cirillo<SUP>9</SUP>, European Reference Laboratory Network for TB (ERLN-TB) members<SUP>10</SUP>, Y Balabanova<SUP>1</SUP><SUP>,3</SUP>
<SUP>1</SUP>Department for Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany - 2 European Public Health Microbiology Training Programme (EUPHEM), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden - 3 Queen Mary College, Barts and the London School of Medicine, University of London, London, United Kingdom - 4 National Mycobacterium Reference Laboratory, Public Health England, London, United Kingdom ? 5 National Reference Center for Mycobacteria, Forschungszentrum Borstel, Borstel, Germany - 6 National Mycobacterium Reference Laboratory, Croatian National Institute of Public Health, Zagreb, Croatia - 7 Infectious Diseases and Tuberculosis Hospital, Affiliate of Vilnius University Hospital Santariskiu Klinikos, Vilnius, Lithuania ? 8 Riga East University Hospital, Centre of Tuberculosis and Lung Diseases, Riga, Latvia - 9 San Raffaele Scientific Institute, Milan, Italy - 10 Members of the network are listed at the end of the article

Citation style for this article: Sanchini A, Fiebig L, Drobniewski F, Haas W, Richter E, Katalinic-Jankovic V, Pimkina E, Skenders G, Cirillo DM, European Reference Laboratory Network for TB (ERLN-TB) members, Balabanova Y. Laboratory diagnosis of paediatric tuberculosis in the European Union/European Economic Area: analysis of routine laboratory data, 2007 to 2011. Euro Surveill. 2014;19(11):pii=20744. Available online: http://www.eurosurveillance.org/View...rticleId=20744
Date of submission: 13 June 2013


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.