Clinical and radiological study of Suruí indigenous children and adolescents, Amazon Region, Brazil

摘要

INTRODUCTION: The average incidence coefficient of tuberculosis in Suruí Indians from Rondônia was 2.500/100.000 inhabitants in 1991-2002. About 50% of these cases were reported in children 15 years-old. METHODS: This study aimed to describe the clinical and radiological characteristics of children and adolescents identified as TB case contacts. A score system for the diagnosis of childhood TB was used and the procedures adopted by local health services were in accordance with national guidelines. RESULTS: 52 chest X-rays of 37 indigenous subjects were analyzed; of these, 51.9% were abnormal. Some X-rays showed more than two lesions, making a total of 36 independent events. Infiltrates (38.9%), calcifications (38.9%), cavitations (11.1%) and atelectasis/pleural effusion (11.1%) were observed. Among the abnormal images, 22.2% were probably indicated active TB and 33.3% showed sequelae. Confrontation with the guidelines revealed 52.6% of divergent procedures. CONCLUSIONS: The presence of latent tuberculosis infection (LTBI) and active TB between children and adolescents are indicators of active and progressive transmission of Mycobacterium tuberculosis. The X-rays showed high frequencies of infiltrates and calcifications, which are compatible with primary infection in early childhood. However, these lesions are not different from those observed among other groups and do not suggest immune deficiencies. The divergences presented show that the best moment for the treatment of LTBI went unnoticed by local personnel. In conclusion, the use of a score system is fundamental for the correct diagnosis of TB in childhood, as is conducting bacilloscopy and sputum culture in adolescents able to expectorate.