Diagnosis of paediatric TB using Xpert® MTB/RIF Ultra on fresh respiratory samples

Sabi, I., Olomi, W., Nkereuwem, E., Togun, T., Gomez, M. P., Sylla, M., Diarra, B., Sanogo, M., Sichone, E., Mahiga, H., Njeleka, F., Ebonyi, A. O., Egere, Uzochukwu ORCID: https://orcid.org/0000-0002-0282-6004, Ntinginya, N. E., Hoelscher, M., Heinrich, N. and Kampmann, B. (2022) 'Diagnosis of paediatric TB using Xpert® MTB/RIF Ultra on fresh respiratory samples'. International Journal of Tuberculosis and Lung Disease, Vol 26, Issue 9, pp. 862-868.

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Abstract

OBJECTIVE: To evaluate the diagnostic accuracy of Xpert® MTB/RIF Ultra (Ultra) on fresh respiratory samples for the diagnosis of pulmonary TB (PTB) in children.

METHODS: Between July 2017 and December 2019, children with presumed TB were prospectively enrolled at clinical sites in three African countries. Children were assessed using history, physical examination and chest X-ray. Sputum or gastric aspirate samples were analysed using Ultra and culture. The diagnostic accuracy of Ultra was calculated against culture as the reference standard.

RESULTS: In total, 547children were included. The median age was 4.7 years, 77 (14.1%) were HIV infected and 77 (14.1%) had bacteriologically confirmed TB. Ultra detected an additional 20 cases in the group of children with negative culture results. The sensitivity of Ultra was 66.3% (95% CI 47–82), and the specificity was 95.4% (95% CI 89–99) when assessed against culture as the reference standard.

CONCLUSION: Despite the improved performance of Ultra as compared to Xpert as was previously reported, its sensitivity remains sub-optimal for the detection of TB in children. Ultra detected additional 20 cases which otherwise could not have been detected by culture alone, suggesting that the latter is an imperfect reference standard.

Item Type:	Article
Subjects:	WF Respiratory System > Tuberculosis > WF 200 Tuberculosis (General) WF Respiratory System > Tuberculosis > WF 220 Diagnosis. Prognosis WF Respiratory System > Tuberculosis > WF 415 Tuberculosis in childhood WS Pediatrics > Diseases of Children and Adolescents > By System > WS 280 Respiratory system
Faculty: Department:	Clinical Sciences & International Health > International Public Health Department
Digital Object Identifer (DOI):	https://doi.org/10.5588/ijtld.22.0007
SWORD Depositor:	JISC Pubrouter
Depositing User:	JISC Pubrouter
Date Deposited:	17 Nov 2022 11:23
Last Modified:	16 Jun 2023 09:58
URI:	https://archive.lstmed.ac.uk/id/eprint/21078

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