In early diagnosis of neonatal sepsis, compared with procalcitonin, presepsin seems to provide better early diagnostic value with consequent possible faster therapeutical decision making and possible positive impact on outcome of neonates.
Introduction: Diagnosis of Tuberculosis (TB) in children is difficult because the clinical presentation is not specific, the chest X-ray interpretation has low accuracy and sputum sample is difficult to obtain. Antigen detection test such as rapid urine LAM is a non-invasive alternative for diagnosing TB . Lipoarabinomannan (LAM) is the main component of M.tuberculosis cell wall.
Aim:To determine the diagnostic value of urinary LAM antigen for diagnosis of childhood TB.
Materials and Methods:In the present cross-sectional study, subjects were included using consecutive sampling method. All the children aged 0-14 years Suspected of pulmonary or extra pulmonary TB suffering from cough more than two weeks, fever without clear aetiology, loss of body weight or poor weight gain, fatigue, malaise, chronic lymph node enlargement, spine angulation, joint swelling and had history of contact with positive sputum smear adult TB patient were enrolled in the study. Pulmonary and extra pulmonary diagnosis was based on clinical presentation, Tuberculin Skin Test (TST), chest X-ray, Acid Fast Bacillus (AFB) staining and or sputum culture. Urinary LAM level was measured by using Enzyme-Linked Immunosorbent Assay (ELISA). Cut off value and Area Under the Curve (AUC) were determined using ROC statistical analysis (SPSS 21.0). Sensitivity and specificity was measured from 2x2 cross table.Results: Out of 61 subjects suspected as TB, 49 (80.3%) were eventually diagnosed with TB. Of those diagnosed with TB, 21 (42.9%) were microbiologically confirmed cases either by sputum microscopy (34.7%) or culture (8.2%), whereas 28 subjects were unconfirmed cases (57.1%). The urinary LAM level was higher in subjects with TB (1.80+1.02) mg/l compared to non-TB group (0.46+0.3) mg/l; p<0.001(independent t-test). Urine LAM had 83% sensitivity and 85% specificity with cut off value 0.98 mg/l using microbiological and clinical confirmation as standard reference and 33% sensitivity and 60% specificity with cut off value 1.69 mg/l using microbiological confirmation only.
Conclusion:Urinary LAM has good diagnostic value for childhood TB diagnosis.
The purpose of this study is to discuss and develop Spatial-Temporal Autologistic Regression Model (STARM) to represent spreading of the Aedes aegypti which is indicated by the endemic level of DHF (Dengue Hemorrhagic Fever) in East Java. The method which is used to estimate STARM parameter is Bayesian method with Markov Chain Monte Carlo (MCMC) and Gibbs Sampler simulation. This study observed 38 districts as spatial lattice units, meanwhile temporal unit is represented by monthly period of evidence (January-December) in 2002-2008. Result of the research was obtained STARM model that indicate the spreading pattern of the Aedes aegypti that is indicated by the endemic level of DHF incidence in East Java have spatially and temporally positive correlation. Model validation using 95% credible interval shows that all estimators are significant. This is also supported by a MAE value 0.09 and the percentage of correctly classified predicted data 90%, which means there are 90 correctly classified data of 100 prediction data.
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