Sputum Concentration Improves Diagnosis Of Pulmonary Tuberculosis CasesIn Children At A Tertiary Care Institution In Rwanda

Background: Pulmonary tuberculosis diagnosis by direct sputum smear microscopy is still questionable because of its low sensitivity and this technique is not sufficient to diagnose pulmonary tuberculosis especially in people who are not able to spit out properly like children and old people; therefore another more sensitive conventional technique like concentrated sputum smear microscopy is needed in patients suspected of having pulmonary tuberculosis. We aimed to find out if the sputum concentration technique can be more sensitive than direct smear microscopy in the diagnosis of pulmonary tuberculosis according to age groups. Methods: This study was a cross-sectional, conducted on 70 participants at CHUK. The sputa were examined microscopically on direct and concentrated smears and result compared to culture. Finally the data were analyzed with MS excel and SPSS. Results: A total of 210 sputa were analyzed by direct and concentration methods with culture as a gold standard. In patients under 15 years both methods were different in sensitivity (25% vs. 75%, CI= 95%, P= 0.047), in patients of 15 years of age and more, both methods had the same sensitivity (75% vs. 75%, CI= 95%, P = 0, 87). Regardless of age groups both methods were different in sensitivity (80% vs.90.9%, C.I= 95%, P = 0.001). Conclusion: Sputum concentration is more sensitive than direct technique especially in children under 15 years. We would recommend all researchers involved in tuberculosis to increase the sample size and use different study sites to validate this method before its implementation universally.