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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| Format: | Article |
| Language: | English |
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International Union Against Tuberculosis and Lung Disease (The Union)
2024-10-01
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| Series: | IJTLD Open |
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| Online Access: | https://www.ingentaconnect.com/contentone/iuatld/ijtldo/2024/00000001/00000010/art00003 |
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| author | S. Kabir S. Choudhury T. Rahman S.M.M. Rahman M.K.M. Uddin A. Nashra A. Hossain S. Naher K.M.S. Towhid L. Shahrin S. Ahmed P. Daru J. Hoffmann S. Banu |
| author_facet | S. Kabir S. Choudhury T. Rahman S.M.M. Rahman M.K.M. Uddin A. Nashra A. Hossain S. Naher K.M.S. Towhid L. Shahrin S. Ahmed P. Daru J. Hoffmann S. Banu |
| author_sort | S. Kabir |
| collection | DOAJ |
| description | 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. |
| format | Article |
| id | doaj-art-938219c014ce450d861b15de4dc67932 |
| institution | Kabale University |
| issn | 3005-7590 |
| language | English |
| publishDate | 2024-10-01 |
| publisher | International Union Against Tuberculosis and Lung Disease (The Union) |
| record_format | Article |
| series | IJTLD Open |
| spelling | doaj-art-938219c014ce450d861b15de4dc679322025-01-23T13:28:38ZengInternational Union Against Tuberculosis and Lung Disease (The Union)IJTLD Open3005-75902024-10-0111043744210.5588/ijtldopen.24.03343Stool Xpert® MTB/RIF Ultra for TB diagnosis in children: experience from a national scale-up programmeS. Kabir0S. Choudhury1T. Rahman2S.M.M. Rahman3M.K.M. Uddin4A. Nashra5A. Hossain6S. Naher7K.M.S. Towhid8L. Shahrin9S. Ahmed10P. Daru11J. Hoffmann12S. Banu13Progamme on Emerging Infections, Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh;Progamme on Emerging Infections, Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh;Progamme on Emerging Infections, Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh;Progamme on Emerging Infections, Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh;Progamme on Emerging Infections, Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh;Progamme on Emerging Infections, Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh;Progamme on Emerging Infections, Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh;Progamme on Emerging Infections, Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh;National Tuberculosis Control Programme, Dhaka, Bangladesh;Clinical and Diagnostic Services, Office of Executive Director, icddr,b, Dhaka, Bangladesh;Progamme on Emerging Infections, Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh;Progamme on Emerging Infections, Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh;Fondation Mérieux, Lyon, France.Progamme on Emerging Infections, Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh;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.https://www.ingentaconnect.com/contentone/iuatld/ijtldo/2024/00000001/00000010/art00003tuberculosisxpert mtb/rif ultranon-invasivehigh tb burden countrydiagnosisbangladeshpaediatric tb |
| spellingShingle | S. Kabir S. Choudhury T. Rahman S.M.M. Rahman M.K.M. Uddin A. Nashra A. Hossain S. Naher K.M.S. Towhid L. Shahrin S. Ahmed P. Daru J. Hoffmann S. Banu Stool Xpert® MTB/RIF Ultra for TB diagnosis in children: experience from a national scale-up programme IJTLD Open tuberculosis xpert mtb/rif ultra non-invasive high tb burden country diagnosis bangladesh paediatric tb |
| title | Stool Xpert® MTB/RIF Ultra for TB diagnosis in children: experience from a national scale-up programme |
| title_full | Stool Xpert® MTB/RIF Ultra for TB diagnosis in children: experience from a national scale-up programme |
| title_fullStr | Stool Xpert® MTB/RIF Ultra for TB diagnosis in children: experience from a national scale-up programme |
| title_full_unstemmed | Stool Xpert® MTB/RIF Ultra for TB diagnosis in children: experience from a national scale-up programme |
| title_short | Stool Xpert® MTB/RIF Ultra for TB diagnosis in children: experience from a national scale-up programme |
| title_sort | stool xpert r mtb rif ultra for tb diagnosis in children experience from a national scale up programme |
| topic | tuberculosis xpert mtb/rif ultra non-invasive high tb burden country diagnosis bangladesh paediatric tb |
| url | https://www.ingentaconnect.com/contentone/iuatld/ijtldo/2024/00000001/00000010/art00003 |
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