@article{fdi:010077030,
  title = {{A} treatment-decision score for {HIV}-infected children with suspected tuberculosis},
  author = {{M}arcy, {O}. and {B}orand, {L}. and {U}ng, {V}. and {M}sellati, {P}hilippe and {T}ejiokem, {M}. and {H}uu, {K}. {T}. and {C}hau, {V}. {D}. and {T}ran, {D}. {N}. and {A}teba-{N}dongo, {F}. and {T}etang-{N}diang, {S}. and {N}acro, {B}. and {S}anogo, {B}. and {N}eou, {L}. and {G}oyet, {S}. and {D}im, {B}. and {P}ean, {P}. and {Q}uillet, {C}. and {F}ournier, {I}. and {B}erteloot, {L}. and {C}arcelain, {G}. and {G}odreuil, {S}. and {B}lanche, {S}. and {D}elacourt, {C}. and {ANRS} {P}aanther 01 {S}tudy {G}roup},
  editor = {},
  language = {{ENG}},
  abstract = {{I}n this study, we developed a treatment-decision score in 438 {HIV}-infected children with presumptive tuberculosis enrolled in {B}urkina {F}aso, {C}ambodia, {C}ameroon, and {V}ietnam. {BACKGROUND}:{D}iagnosis of tuberculosis should be improved in children infected with {HIV} to reduce mortality. {W}e developed prediction scores to guide antituberculosis treatment decision in {HIV}-infected children with suspected tuberculosis.{METHODS}:{HIV}-infected children with suspected tuberculosis enrolled in {B}urkina {F}aso, {C}ambodia, {C}ameroon, and {V}ietnam ({ANRS} 12229 {PAANTHER} 01 {S}tudy), underwent clinical assessment, chest radiography, {Q}uantiferon {G}old {I}n-{T}ube ({QFT}), abdominal ultrasonography, and sample collection for microbiology, including {X}pert {MTB}/{RIF} ({X}pert). {W}e developed 4 tuberculosis diagnostic models using logistic regression: (1) all predictors included, (2) {QFT} excluded, (3) ultrasonography excluded, and (4) {QFT} and ultrasonography excluded. {W}e internally validated the models using resampling. {W}e built a score on the basis of the model with the best area under the receiver operating characteristic curve and parsimony.{RESULTS}:{A} total of 438 children were enrolled in the study; 251 (57.3%) had tuberculosis, including 55 (12.6%) with culture- or {X}pert-confirmed tuberculosis. {T}he final 4 models included {X}pert, fever lasting >2 weeks, unremitting cough, hemoptysis and weight loss in the past 4 weeks, contact with a patient with smear-positive tuberculosis, tachycardia, miliary tuberculosis, alveolar opacities, and lymph nodes on the chest radiograph, together with abdominal lymph nodes on the ultrasound and {QFT} results. {T}he areas under the receiver operating characteristic curves were 0.866, 0.861, 0.850, and 0.846, for models 1, 2, 3, and 4, respectively. {T}he score developed on model 2 had a sensitivity of 88.6% and a specificity of 61.2% for a tuberculosis diagnosis.{CONCLUSIONS}:{O}ur score had a good diagnostic performance. {U}sed in an algorithm, it should enable prompt treatment decision in children with suspected tuberculosis and a high mortality risk, thus contributing to significant public health benefits.},
  keywords = {{BURKINA} {FASO} ; {CAMEROUN} ; {CAMBODGE} ; {VIET} {NAM}},
  booktitle = {},
  journal = {{P}ediatrics},
  volume = {144},
  numero = {3},
  pages = {art. e20182065 [26 ]},
  ISSN = {0031-4005},
  year = {2019},
  DOI = {10.1542/peds.2018-2065},
  URL = {https://www.documentation.ird.fr/hor/fdi:010077030},
}