C106-03 Lung Point-of-care Ultrasound for Screening Child Contacts of Tuberculosis Cases: A Preliminary Single-center Study in Cotonou, Benin

Abstract Introduction The role of lung point-of-care ultrasound (POCUS) in screening child contacts of tuberculosis (TB) cases remains understudied, particularly in resource-limited settings. This study aimed to evaluate the utility of lung POCUS in screening children who had contact with bacteriologically confirmed pulmonary tuberculosis (BCPT) cases at the National Hospital for Tuberculosis and Pulmonary Diseases (NHTPD) in Cotonou, Benin. Methods We conducted a preliminary observational, cross-sectional study from September 2022 to January 2023. The study included children aged 29 days to 17 years who had contact with BCPT cases. Lung ultrasound examinations were performed and interpreted by two independent readers blinded to clinical and paraclinical data. Results were compared with chest radiography findings. Children were classified as having either active TB (bacteriologically confirmed or clinically diagnosed with pleural effusion and/or hilar adenopathies on chest X-ray) or unlikely TB. Results A total of 105 child contacts (median age: 7.0 ± 4.7 years, sex ratio 0.9) were included from 34 BCPT index cases (median age: 32 years, sex ratio 1.26). TB prevalence was 10.5% among child contacts, with higher rates in children under five years (21.6%) and symptomatic contacts (36.0%). Lung POCUS lesions in ≥ 2 quadrants showed 63.6% sensitivity, 31.9% specificity, 9.6% positive predictive value, and 88.2% negative predictive value (NPV) for TB diagnosis. Supra-centimetric consolidation on lung POCUS was significantly associated with TB diagnosis (p = 0.01) and was found exclusively in children with TB (18.2%). Abnormal findings were more frequent with POCUS (79.4%) than chest radiography (23.5%). The mean duration of the POCUS procedure was 17.0 minutes, with duration ranging from 4 to 32 minutes. During the POCUS procedure, the main issues recorded were crying (21.6%) and agitation (8.1%), exclusively encountered in children less than 5 years old. Conclusion Lung POCUS demonstrates a high negative predictive value , suggesting its potential as an effective tool for ruling out TB in child contacts of bacteriologically confirmed pulmonary tuberculosis cases. This capability could inform clinical decision-making regarding TB preventive treatment initiation in children. The procedure’s relatively short duration and acceptable tolerability profile support its feasibility for implementation in resource-limited settings. This abstract is funded by: None