Stool Xpert® MTB/RIF Ultra for TB diagnosis in children: experience from a national scale-up programme
INTRODUCTION: We describe the programmatic scale-up of stool testing using Xpert® MTB/RIF Ultra (Ultra), as recommended by the WHO to improve childhood pulmonary TB (PTB) diagnosis. METHODS: USAID's Alliance for Combating TB in Bangladesh Activity, in collaboration with the National TB Control...
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| Main Authors: | , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
International Union Against Tuberculosis and Lung Disease (The Union)
2024-10-01
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| Series: | IJTLD Open |
| Subjects: | |
| Online Access: | https://www.ingentaconnect.com/contentone/iuatld/ijtldo/2024/00000001/00000010/art00003 |
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| Summary: | INTRODUCTION: We describe the programmatic scale-up of stool testing using Xpert® MTB/RIF Ultra (Ultra), as recommended by the WHO to improve childhood pulmonary TB (PTB) diagnosis. METHODS: USAID's Alliance for Combating TB in Bangladesh Activity, in collaboration with the National TB Control Programme, is implementing a stool-based diagnostic approach at 51 healthcare facilities in Bangladesh to improve PTB detection. Specimens from children (<15 years) with presumptive TB were tested using ‘stool Ultra’ with routine TB diagnostics. Physicians confirmed TB diagnosis and provided treatment as per national guidelines. RESULTS: Between March 2022 and December 2023, 16,429 specimens were tested, 871 (5.3%) were positive, and 642 (73.7%) showed ‘trace detected’ results. Positivity was significantly higher among females, and children presented with ‘only cough ≥2 weeks’, ‘cough ≥2 weeks + weight loss’, or ‘fever ≥2 weeks, weight loss, fatigue + contact history’. Positivity was higher among ‘10–14 years old’ children; however, ‘trace detected’ was highest among ‘5–9 years’, followed by children aged ‘>2–<5 years’ and ‘0–2 years’. CONCLUSIONS: Testing stools using Ultra provides a more effective way of diagnosing bacteriologically positive PTB in children. However, positivity varies with presenting symptoms/criteria, highlighting the need for careful diagnostic evaluation to ensure optimum use of limited diagnostic resources. |
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| ISSN: | 3005-7590 |