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Open Access Research article

Fine-needle aspiration for diagnosis of tuberculous lymphadenitis in children in Bangui, Central African Republic

Minime-Lingoupou Fanny1*, Narcisse Beyam1, Jean Chrusostome Gody2, G Zandanga1, F Yango1, Alexandre Manirakiza1, Leen Rigouts3, Catherine Pierre-Audigier4, Brigitte Gicquel4 and Gustave Bobossi2

Author affiliations

1 Laboratoire des Mycobactéries, Institut Pasteur de Bangui, Bangui, Central African Republic (CAR

2 Hôpital pédiatrique de Bangui, Bangui, CAR

3 Mycobacteriology Unit, Institute of Tropical Medicine, and Department of Pharmaceutical, Veterinary and Biomedical Sciences, University of Antwerp, Antwerp, Belgium

4 Unité de Génétique Mycobactérienne, Institut Pasteur, Paris, France

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Citation and License

BMC Pediatrics 2012, 12:191  doi:10.1186/1471-2431-12-191

Published: 13 December 2012

Abstract

Background

Tuberculosis (TB) is a major cause of childhood morbidity and mortality in developing countries. One of the main difficulties is obtaining adequate specimens for bacteriological confirmation of the disease in children.

The aim of this study is to evaluate the adequacy of fine-needle aspiration (FNA) for the diagnosis of TB.

Methods

In a prospective study conducted at the paediatric hospital in Bangui in 2007–2009, we used fine-needle aspiration to obtain samples for diagnosis of TB from 131 children aged 0–17 years with persistent lymphadenitis.

Results

Fine-needle aspiration provided samples that could be used for bacteriological confirmation of TB. Ziehl-Neelsen staining for acid-fast bacilli was positive in 42.7% of samples, and culture identified TB in 67.2% of cases. Of 75 samples that were stain-negative, 49 (65.3%) were culture-positive, while 12 stain-positive samples remained culture-negative. Ten of the 12 stain-positive, culture-negative samples were from patients who had received previous antimicrobial therapy. With regard to phenotypic drug susceptibility, 81/88 strains (91.1%) were fully susceptible to isoniazid, rifampicin, ethambutol and streptomycin, six (6.8%) were resistant to one drug, and one multidrug-resistant strain was found.

Conclusions

Fine-needle aspiration is simple, cost-effective and non-invasive and can be performed by trained staff. Combined with rapid molecular diagnostic tests, fine-needle aspirates could improve the diagnosis of TB and provide valuable information for appropriate treatment and drug resistance.

Keywords:
Tuberculosis; Lymphadenitis; Fine needle aspiration; Diagnosis