Background: One study was conducted to evaluate the efficacy of ELISA serological test for the detection of IgG antibodies against ESAT-6 synthetic peptides and the recombinant ESAT-6 antigen (rESAT-6). Methods: The study was carried out on children with pulmonary tuberculosis and healthy controls (13 cases and 63 controls). Informed consents of their parents or guardians were taken. They were subjected to clinical examination, relevant laboratory investigations, tuberculin test (epidemiological link with confirmed case), chest radiograph and therapeutic positive test. Relevant body fluids (sputum and gastric fluid) were subjected to biochemical test adenosine deaminase (ADA) and bacteriological tests (Lowëstein-Jensen (LJ) and Ziehl Neelson (ZN)) and PCR. Sera samples were analyzed for antibodies against 5 ESAT-6 synthetic peptides (12033, 12034, 12035, 12036 and 12037) and rESAT-6. The Utility of these methods was evaluated using receiver operating characteristic curve (ROC) analysis. Results: ELISA test using ESAT-6 peptide (anti-12036) showed a significantly higher sensitivity (100%) than ADA, LJ medium culture method and ZN staining and PCR tests (30% ADA, 0% ZN staining, 0% LJ culture and 12.5% PCR) in all patients (p < 0.001). ADA biochemical test was highly specific (100%), followed by anti-12033 test (95.2%). Anti-rESAT-6 showed been lowly sensible and specific. Conclusion: In view of the convenience, low cost and high sensitivity and specificity, the ELISA tests using a combination of ESAT-6 peptides could have a promising future in the diagnosis of childhood tuberculosis. Abstracts for SupplementInternational Journal of Infectious DiseasesVol. 14Preview Full-Text PDF Open Archive