Screening of childhood tuberculosis with Pakistan pediatric association scoring chart system

Objective: the objective of the study was to determine the sensitivity of pakistan pediatric association scoring chart system as a diagnostic tool for childhood tuberculosis (ppascfsctb) in the admitted children. methods: this prospective study was conducted in government allama iqbal memorial dhq (civil) hospital sialkot pakistan from 1st june 2010 to 31st may 2012. all the children admitted in the department of pediatrics were enrolled for screening during this period,except neonates admitted in nursery neonatal unit. data were collected on a performa designed according to the ppa scoring chart for screening childhood tb(ppascfsctb). results: out of 11659 admitted cases in 2 years,240 children scored 7 or more scores on ppascfsctb. 220 out of 240 (92%) cases were diagnosed as cases of childhood tb on the basis of response to anti tuberculosis drugs giving a sensitivity of ppascfsctb as 92 % at 7 or more scores. among 220 cases of tuberculosis 114 (51.8%) cases were male with male to female ratio of (1:1). 121 (55%) cases were from rural area while 99 (45%)cases came from urban area. 186 (84.5%) cases were socioeconomically low (having income < rs. 7000/month) while only 14 (6.3 %) cases were offspring of the parents having income more than rs. 30,000/month,rest of the 20 (9.0%) cases belonging to middle socioeconomic status with income in between rs. 7100 - 30,000. in 88 (40 %) cases bcg scar was absent. the history of whooping cough,mumps,chicken pox and measles was present in 25 (11.36 %) cases in the last three months before the commencement of the disease. history of close contact with tb patient was present in 84 (38.1%) cases and in 76 (34.5%) cases third degree malnutrition was found. the positive radiological finding was found in 117 (53.1%) cases in the form of lymphadenopathy,opacities,consolidation,pleural effusion and milliary mottling. cold abscesses with discharging sinuses were seen in cervical lymph node in 8 (3.6%) cases,in axillary lymph nodes in 6 (2.7%) cases and in inguinal lymph nodes 1(0.45%) case. psoas abscess with caries spine was found in 1 case (0.45 %). conclusion: p.p.a scoring chart system is a simple and effective tool to screen the childhood t.b.