Abstract
Six health facilities in Dar es Salaam, Tanzania. To evaluate the use of stool specimens in the diagnostic workup of paediatric TB using the Xpert® MTB/RIF assay. Between December 2018 and May 2019, we performed a cross-sectional diagnostic study of children aged between 1 month and 14 years with presumptive TB. A single stool specimen was tested using Xpert. The result was compared with the reference microbiological standard for respiratory or gastric specimens tested using Xpert and/or solid culture. The sensitivity, specificity and predictive values of stool Xpert assay were assessed. A total of 225 children with a median age of 2.17 years (IQR 1.16-5.19) were enrolled; 165/225 (73.3%) were aged <5 years. Of 225 children, 8 (3.6%) were diagnosed with TB as they were culture- or Xpert-positive on sputum/gastric aspirate. The stool Xpert assay showed a sensitivity of 62.5% (95% CI 25-92) and specificity of 100% (95% CI 98-100) against the reference standard. Use of the Xpert assay on stool specimens had a moderate sensitivity and high specificity in the diagnosis of pulmonary TB in children. Our data adds to the body of evidence for the use of Xpert assay on stool as a non-respiratory specimen to complement conventional methods used to diagnose the disease.
Highlights
The WHO estimated that 10 million people developed TB in 2019, of which children accounted for approximately 12% of cases, with the Africa region having the second highest number of notifications after South-East Asia.[1]
We conducted this study to evaluate the performance of stool Xpert assay in children suspected of having TB across six health facilities in Dar es Salaam, Tanzania, against microbiological confirmation as the reference standard
The use of stool for Xpert had a 62.5% sensitivity and a 100% specificity when compared to the reference standard
Summary
The WHO estimated that 10 million people developed TB in 2019, of which children (aged 15 years) accounted for approximately 12% of cases, with the Africa region having the second highest number of notifications after South-East Asia.[1]. In many resource-limited settings, including Tanzania, a paediatric TB score chart is used to aid in the diagnosis of TB despite its widely varying sensitivity and specificity, especially in children with HIV co-infection.[9,10]. Studies have documented stool as a possible specimen for detecting TB using Xpert® MTB/RIF assay (Cepheid, Sunnyvale, CA, USA) among pulmonary TB patients.[11,12,13,14,15,16,17,18,19,20,21] Stool is a much easier sample to obtain, in younger children, and could aid in the diagnosis of paediatric TB. We conducted this study to evaluate the performance of stool Xpert assay in children suspected of having TB across six health facilities in Dar es Salaam, Tanzania, against microbiological confirmation as the reference standard
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
