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Home / The International Journal of Tuberculosis and Lung Disease, Volume 21, Number 2

Open Access Stool Xpert® MTB/RIF test for the diagnosis of childhood pulmonary tuberculosis at primary clinics in Zimbabwe

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OBJECTIVE: To evaluate the diagnostic performance of Xpert® MTB/RIF on stool samples from children with clinical suspicion of pulmonary tuberculosis (PTB) at primary care clinics.

DESIGN: A cross-sectional diagnostic evaluation enrolling 5–16 year olds from whom one induced sputum (IS) sample was tested for microbiological TB confirmation. Results of a single stool sample tested using Xpert were compared against microbiologically confirmed TB, defined as a positive result on sputum microscopy and/or culture and/or IS Xpert.

RESULTS: Of 222 children enrolled, 218 had complete microbiological results. The median age was 10.6 years (interquartile range 8–13). TB was microbiologically confirmed in 19/218 (8.7%) children. Of these, respectively 5 (26%), 9 (47%) and 15 (79%) were smear-, culture- and IS Xpert-positive. Stool Xpert was positive in 13/19 (68%) microbiologically confirmed cases and 4/199 (2%) microbiologically negative cases. Stool Xpert detected 76.9% (10/13) of human immunodeficiency virus (HIV) infected and 50% (3/6) of non-HIV-infected children with microbiologically confirmed TB (P = 0.241).

CONCLUSION: Stool Xpert is a potential alternative screening test for children with suspected TB if sputum is unavailable. Strategies to optimise the diagnostic yield of stool Xpert assay need further study.

Keywords: GeneXpert; children; faecal specimen

Document Type: Research Article

Affiliations: 1: University of Zimbabwe College of Health Sciences, Medical Laboratory Sciences, Harare 2: University of Zimbabwe College of Health Sciences, Research Support Centre, Harare 3: Biomedical Research and Training Institute, Harare, Zimbabwe 4: Biomedical Research and Training Institute, Harare, Zimbabwe, Clinical Research Department, London School of Hygiene & Tropical Medicine, London, UK 5: University of Zimbabwe College of Health Sciences, Medical Laboratory Sciences, Harare, Traditional Medical Laboratory, University of KwaZulu-Natal, Durban, South Africa

Publication date: 01 February 2017

This article was made available online on 15 December 2016 as a Fast Track article with title: "Stool Xpert® MTB/RIF test for the diagnosis of childhood pulmonary tuberculosis at primary clinics in Zimbabwe".

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  • The International Journal of Tuberculosis and Lung Disease (IJTLD) is for clinical research and epidemiological studies on lung health, including articles on TB, TB-HIV and respiratory diseases such as COVID-19, asthma, COPD, child lung health and the hazards of tobacco and air pollution. Individuals and institutes can subscribe to the IJTLD online or in print – simply email us at [email protected] for details.

    The IJTLD is dedicated to understanding lung disease and to the dissemination of knowledge leading to better lung health. To allow us to share scientific research as rapidly as possible, the IJTLD is fast-tracking the publication of certain articles as preprints prior to their publication. Read fast-track articles.

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