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. 2017 Sep 8;10(1):473.
doi: 10.1186/s13104-017-2806-3.

Evaluation of Xpert MTB/RIF testing for rapid diagnosis of childhood pulmonary tuberculosis in children by Xpert MTB/RIF testing of stool samples in a low resource setting

Zahra Hasan  1 , Sadia Shakoor  2 , Fehmina Arif  3 , Aisha Mehnaz  3 , Alnoor Akber  2 , Marium Haider  3 , Akbar Kanji  2 , Rumina Hasan  2
Affiliations

Evaluation of Xpert MTB/RIF testing for rapid diagnosis of childhood pulmonary tuberculosis in children by Xpert MTB/RIF testing of stool samples in a low resource setting

Zahra Hasan et al. BMC Res Notes. .

Abstract

Objective: Children with tuberculosis (TB) remain underdiagnosed due to difficulty in testing for Mycobacterium tuberculosis (MTB) infection. We evaluated the Xpert MTB/RIF assay for respiratory and stool testing in children for pulmonary TB through a cross-sectional study at tertiary care facilities in Karachi, Pakistan. Fifty children aged 0-15 years screened by a modified Kenneth-Jones (KJ) score were included. Mycobacterial culture of respiratory samples was the microbiological standard against stool Xpert TB results. All positive TB cases were compared against a treatment response standard (TRS).

Results: Twelve study subjects were diagnosed by Xpert TB and nine by MTB culture. Compared with culture [gastric aspirates (GA)/sputum (spm)], stool Xpert TB had a sensitivity of 88.9% (95% CI 50.7-99.4) and a specificity of 95% (95% CI 81.8-99.1). Xpert TB stool versus GA/spm had sensitivity of 81.8% (95% CI 47.8-96.8) and specificity of 94.7% (95% CI 84.6-99.9). We found good agreement (kappa scores of >0.8) between stool Xpert, GA/spm Xpert and GA/spm culture. Stool Xpert PPV and NPV against TRS was 100 and 82.1% respectively. Stool Xpert TB is a relatively easy option for diagnosis for pulmonary childhood TB in a high burden low-resource setting.

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Figures

Fig. 1
Fig. 1
Outline of study. ‘#’ additional tests done for this study together with routine GA/sputum MTB culture were TB Xpert on GA/sputum and stool specimens of each study subject; asterisk one study subject expired prior to collection of stool sample; double asterisk end of treatment follow up was available for 17 cases only as one study subject expired
See this image and copyright information in PMC

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