Lessons Learned from Early Implementation and Scale-up of Stool-Based Xpert Testing to Diagnose Tuberculosis in Children

In 2020, fecal (stool) testing was recommended for diagnosing Mycobacterium tuberculosis complex (MTBC) infection in children by using the Cepheid Xpert MTB/RIF assay; since then, countries have begun implementing stool-based testing, often as part of a comprehensive strategy to enhance TB case fin...

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Main Authors: Eveline Klinkenberg, Petra de Haas, Charles Manyonge, Joanita Namutebi, Bibiche Mujangi, Hebert Mutunzi, Amri Kingalu, Nkiru Nwokoye, Kuzani Mbendera, Yohannes D. Babo, Gulmira Kalmambetova, Gunta Dravniece, Winnie Mwanza, Ahmed Bedru, Degu D. Jerene, Lisa V. Adams, Andwele Mwansasu, Charlotte Colvin
Format: Article
Language:English
Published: Centers for Disease Control and Prevention 2025-03-01
Series:Emerging Infectious Diseases
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Online Access:https://wwwnc.cdc.gov/eid/article/31/3/24-1580_article
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author Eveline Klinkenberg
Petra de Haas
Charles Manyonge
Joanita Namutebi
Bibiche Mujangi
Hebert Mutunzi
Amri Kingalu
Nkiru Nwokoye
Kuzani Mbendera
Yohannes D. Babo
Gulmira Kalmambetova
Gunta Dravniece
Winnie Mwanza
Ahmed Bedru
Degu D. Jerene
Lisa V. Adams
Andwele Mwansasu
Charlotte Colvin
author_facet Eveline Klinkenberg
Petra de Haas
Charles Manyonge
Joanita Namutebi
Bibiche Mujangi
Hebert Mutunzi
Amri Kingalu
Nkiru Nwokoye
Kuzani Mbendera
Yohannes D. Babo
Gulmira Kalmambetova
Gunta Dravniece
Winnie Mwanza
Ahmed Bedru
Degu D. Jerene
Lisa V. Adams
Andwele Mwansasu
Charlotte Colvin
author_sort Eveline Klinkenberg
collection DOAJ
description In 2020, fecal (stool) testing was recommended for diagnosing Mycobacterium tuberculosis complex (MTBC) infection in children by using the Cepheid Xpert MTB/RIF assay; since then, countries have begun implementing stool-based testing, often as part of a comprehensive strategy to enhance TB case finding among children. On the basis of an experience-sharing workshop in November 2023, we determined insights of 9 early-adopter countries. Across those countries, 71,757 children underwent stool testing over a combined period of 121 months, October 2020–September 2023. A total of 2,892 children were positive for MTBC, and rifampin resistance was confirmed for 43 stool samples. The overall yield of MTBC detection across the countries was 4.1% (range 1.1%–17.3%). Stool collection for Xpert testing was considered noninvasive and as easy as sputum testing. Stool-based testing can be integrated into peripheral healthcare levels as a routine test to increase bacteriologic confirmation among children with presumptive TB.
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publishDate 2025-03-01
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series Emerging Infectious Diseases
spelling doaj-art-9bc22ee7a4dd4fdf9d51a8c5705f413d2025-08-20T02:02:09ZengCenters for Disease Control and PreventionEmerging Infectious Diseases1080-60401080-60592025-03-013131910.3201/eid3103.241580Lessons Learned from Early Implementation and Scale-up of Stool-Based Xpert Testing to Diagnose Tuberculosis in ChildrenEveline KlinkenbergPetra de HaasCharles ManyongeJoanita NamutebiBibiche MujangiHebert MutunziAmri KingaluNkiru NwokoyeKuzani MbenderaYohannes D. BaboGulmira KalmambetovaGunta DravnieceWinnie MwanzaAhmed BedruDegu D. JereneLisa V. AdamsAndwele MwansasuCharlotte Colvin In 2020, fecal (stool) testing was recommended for diagnosing Mycobacterium tuberculosis complex (MTBC) infection in children by using the Cepheid Xpert MTB/RIF assay; since then, countries have begun implementing stool-based testing, often as part of a comprehensive strategy to enhance TB case finding among children. On the basis of an experience-sharing workshop in November 2023, we determined insights of 9 early-adopter countries. Across those countries, 71,757 children underwent stool testing over a combined period of 121 months, October 2020–September 2023. A total of 2,892 children were positive for MTBC, and rifampin resistance was confirmed for 43 stool samples. The overall yield of MTBC detection across the countries was 4.1% (range 1.1%–17.3%). Stool collection for Xpert testing was considered noninvasive and as easy as sputum testing. Stool-based testing can be integrated into peripheral healthcare levels as a routine test to increase bacteriologic confirmation among children with presumptive TB. https://wwwnc.cdc.gov/eid/article/31/3/24-1580_articletuberculosisXpert MTB/RIF UltraNTPstoolfecal testingchildren
spellingShingle Eveline Klinkenberg
Petra de Haas
Charles Manyonge
Joanita Namutebi
Bibiche Mujangi
Hebert Mutunzi
Amri Kingalu
Nkiru Nwokoye
Kuzani Mbendera
Yohannes D. Babo
Gulmira Kalmambetova
Gunta Dravniece
Winnie Mwanza
Ahmed Bedru
Degu D. Jerene
Lisa V. Adams
Andwele Mwansasu
Charlotte Colvin
Lessons Learned from Early Implementation and Scale-up of Stool-Based Xpert Testing to Diagnose Tuberculosis in Children
Emerging Infectious Diseases
tuberculosis
Xpert MTB/RIF Ultra
NTP
stool
fecal testing
children
title Lessons Learned from Early Implementation and Scale-up of Stool-Based Xpert Testing to Diagnose Tuberculosis in Children
title_full Lessons Learned from Early Implementation and Scale-up of Stool-Based Xpert Testing to Diagnose Tuberculosis in Children
title_fullStr Lessons Learned from Early Implementation and Scale-up of Stool-Based Xpert Testing to Diagnose Tuberculosis in Children
title_full_unstemmed Lessons Learned from Early Implementation and Scale-up of Stool-Based Xpert Testing to Diagnose Tuberculosis in Children
title_short Lessons Learned from Early Implementation and Scale-up of Stool-Based Xpert Testing to Diagnose Tuberculosis in Children
title_sort lessons learned from early implementation and scale up of stool based xpert testing to diagnose tuberculosis in children
topic tuberculosis
Xpert MTB/RIF Ultra
NTP
stool
fecal testing
children
url https://wwwnc.cdc.gov/eid/article/31/3/24-1580_article
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