Differences In Serum Procalcitonin Levels In Children With Pulmonary Tuberculosis With Pneumonia

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Differences in Serum Procalcitonin Levels in Children with Pulmonary Tuberculosis and Pneumonia

Introduction

Pulmonary tuberculosis (TB) remains a significant global health concern, particularly in developing countries like Indonesia, where it ranks fifth in incidence. In North Sumatra, the recorded TB cases per 100,000 population in 2014 were 111, which may not accurately reflect the situation, especially in children, where diagnosis can be challenging. Procalcitonin, a biomarker, is thought to aid in diagnosing pulmonary TB and distinguishing it from other airway infections, such as pneumonia. This study aims to determine the difference in serum procalcitonin levels in children suffering from pulmonary TB and pneumonia.

Background

Pulmonary TB is a major public health concern worldwide, with Indonesia being one of the countries most affected. The disease is caused by the bacterium Mycobacterium tuberculosis, which primarily affects the lungs. In children, TB can be particularly challenging to diagnose, as the symptoms can be non-specific and similar to those of other respiratory infections. Accurate diagnosis is crucial, as TB can lead to severe complications, including death, if left untreated.

Procalcitonin is a biomarker that has been shown to be effective in diagnosing bacterial infections, including pneumonia. It is produced in response to the inflammatory process and can help distinguish between bacterial and viral infections. In the case of pneumonia, higher levels of procalcitonin can indicate a bacterial infection, which can also help determine the severity of the infection, detect sepsis, and assess prognosis.

Research Purposes

The primary objective of this study is to determine the difference in serum procalcitonin levels in children suffering from pulmonary TB and pneumonia. This study aims to contribute to the existing body of knowledge on the use of procalcitonin as a biomarker in diagnosing airway infections in children.

Research Methods

This study employed a cross-sectional study design, conducted at the Adam Malik Hajj Center General Hospital, Medan, from June to September 2017. A total of 50 children who met the inclusion criteria, consisting of 25 children with a diagnosis of pulmonary tuberculosis and 25 children with a pneumonia diagnosis, were included in this study. Procalcitonin serum levels were measured before therapy began. The data collected were analyzed using the Kolmogorov-Smirnov test and the Mann-Whitney test.

Research Results

The results of this study showed that the median serum procalcitonin levels in children with pulmonary TB was 0.45 ng/ml, with a range of 0.02-31.00 ng/ml. In contrast, serum procalcitonin levels in children with pneumonia reached 1.03 ng/ml, with a range of 0.07-24.60 ng/ml. However, statistical analysis showed that the difference in serum procalcitonin levels between the two groups was not statistically significant (p = 0.76; IK 95% = 0.64-0.87).

Discussion

Procalcitonin is a biomarker produced in response to the inflammatory process, especially bacterial infections. Generally, serum procalcitonin levels are below 0.1 ng/ml. Procalcitonin values can vary depending on the type of infection that occurs. In the case of pneumonia, higher levels of procalcitonin can indicate a bacterial infection, which can also help in determining the severity of infection, detecting sepsis, and assessing prognosis.

Conversely, tuberculosis infection produces interferon-gamma (IFN-γ), which can suppress procalcitonin production. The results showed that serum procalcitonin levels in children with pneumonia were higher than children suffering from pulmonary TB, which is 1.03 ng/ml compared to 0.45 ng/ml.

Conclusion

Overall, this study shows the absence of significant differences in procalcitonin serum levels between children suffering from pulmonary tuberculosis and pneumonia. This shows that although procalcitonin can be an indicator in the diagnosis of airway infections, this result emphasizes the need for additional diagnosis methods to distinguish between the two conditions, especially in the child's population. Accurate availability of biomarkers is very important for proper diagnosis and effective treatment.

This condition shows the need for more attention from medical parties in diagnosing the disease appropriately, especially in children who are more susceptible to complications due to infection. Further research is needed to explore the use of procalcitonin as a biomarker in diagnosing airway infections in children and to develop more effective diagnostic methods.

Implications

The findings of this study have several implications for the diagnosis and treatment of pulmonary TB and pneumonia in children. Firstly, the results suggest that procalcitonin may not be a reliable biomarker for distinguishing between pulmonary TB and pneumonia in children. This highlights the need for additional diagnostic methods to accurately diagnose these conditions.

Secondly, the study's findings emphasize the importance of accurate diagnosis and treatment of pulmonary TB and pneumonia in children. Delayed or inappropriate treatment can lead to severe complications, including death. Therefore, healthcare providers must be vigilant in diagnosing and treating these conditions in children.

Finally, the study's results suggest that further research is needed to explore the use of procalcitonin as a biomarker in diagnosing airway infections in children. This includes investigating the sensitivity and specificity of procalcitonin in diagnosing pulmonary TB and pneumonia in children and developing more effective diagnostic methods.

Recommendations

Based on the findings of this study, the following recommendations are made:

  1. Further research: Further research is needed to explore the use of procalcitonin as a biomarker in diagnosing airway infections in children.
  2. Development of diagnostic methods: More effective diagnostic methods are needed to accurately diagnose pulmonary TB and pneumonia in children.
  3. Improved diagnosis and treatment: Healthcare providers must be vigilant in diagnosing and treating pulmonary TB and pneumonia in children to prevent severe complications.
  4. Public health education: Public health education campaigns should be implemented to raise awareness about the importance of accurate diagnosis and treatment of pulmonary TB and pneumonia in children.

By implementing these recommendations, healthcare providers can improve the diagnosis and treatment of pulmonary TB and pneumonia in children, ultimately reducing the risk of complications and improving health outcomes.
Frequently Asked Questions (FAQs) about Differences in Serum Procalcitonin Levels in Children with Pulmonary Tuberculosis and Pneumonia

Q: What is procalcitonin, and how is it used in diagnosing airway infections?

A: Procalcitonin is a biomarker produced in response to the inflammatory process, especially bacterial infections. It is used to help diagnose bacterial infections, such as pneumonia, and to distinguish between bacterial and viral infections.

Q: What are the differences in serum procalcitonin levels between children with pulmonary tuberculosis and pneumonia?

A: The study found that serum procalcitonin levels in children with pneumonia were higher than in children with pulmonary TB, with a median of 1.03 ng/ml compared to 0.45 ng/ml. However, the difference was not statistically significant.

Q: Why is accurate diagnosis and treatment of pulmonary TB and pneumonia in children important?

A: Accurate diagnosis and treatment of pulmonary TB and pneumonia in children are crucial to prevent severe complications, including death. Delayed or inappropriate treatment can lead to long-term health consequences and increased healthcare costs.

Q: What are the implications of the study's findings for healthcare providers?

A: The study's findings highlight the need for additional diagnostic methods to accurately diagnose pulmonary TB and pneumonia in children. Healthcare providers must be vigilant in diagnosing and treating these conditions to prevent complications.

Q: What are the limitations of the study?

A: The study had a small sample size and was conducted in a single hospital. Further research is needed to confirm the findings and explore the use of procalcitonin as a biomarker in diagnosing airway infections in children.

Q: What are the recommendations for further research and practice?

A: Further research is needed to explore the use of procalcitonin as a biomarker in diagnosing airway infections in children. More effective diagnostic methods are needed to accurately diagnose pulmonary TB and pneumonia in children. Healthcare providers must be vigilant in diagnosing and treating these conditions to prevent complications.

Q: How can healthcare providers improve the diagnosis and treatment of pulmonary TB and pneumonia in children?

A: Healthcare providers can improve the diagnosis and treatment of pulmonary TB and pneumonia in children by:

  • Using additional diagnostic methods, such as imaging studies and laboratory tests, to confirm the diagnosis
  • Implementing public health education campaigns to raise awareness about the importance of accurate diagnosis and treatment
  • Providing timely and effective treatment to prevent complications
  • Collaborating with other healthcare providers to ensure comprehensive care

Q: What are the potential consequences of not accurately diagnosing and treating pulmonary TB and pneumonia in children?

A: The potential consequences of not accurately diagnosing and treating pulmonary TB and pneumonia in children include:

  • Severe complications, including death
  • Long-term health consequences, such as chronic lung disease and cognitive impairment
  • Increased healthcare costs and resource utilization
  • Spread of infection to others, including family members and healthcare providers

Q: How can parents and caregivers help prevent the spread of pulmonary TB and pneumonia in children?

A: Parents and caregivers can help prevent the spread of pulmonary TB and pneumonia in children by:

  • Ensuring that children receive timely and effective treatment for respiratory infections
  • Practicing good hygiene, such as washing hands frequently and covering the mouth when coughing
  • Avoiding close contact with children who have respiratory infections
  • Getting vaccinated against pneumococcal disease and influenza

By understanding the differences in serum procalcitonin levels between children with pulmonary tuberculosis and pneumonia, healthcare providers can improve the diagnosis and treatment of these conditions, ultimately reducing the risk of complications and improving health outcomes.