Diagnostic accuracy of Xpert MTB/RIF Ultra for childhood tuberculosis in West Africa - a multicenter pragmatic study.

Autor:	Diallo AB; Department of Biological Sciences, Faculty of Pharmacy, Cheikh Anta Diop University, Dakar, Senegal., Edem VF; Medical Research Council Unit The Gambia at the London School of Hygiene and Tropical Medicine, Atlantic Road, Fajara, The Gambia; Department of Immunology, College of Medicine, University of Ibadan and University College Hospital, Ibadan, Nigeria., Fiogbe A; National Teaching Hospital for Tuberculosis and Respiratory Diseases, Cotonou, Republic of Benin; National Tuberculosis Program, Republic of Benin., Osman KA; Department of Paediatrics and Child Health, Korle Bu Teaching Hospital and University of Ghana Medical School, Accra, Ghana., Tolofoudie M; University Clinical Research Centre-SEREFO Laboratory, University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali., Somboro A; University Clinical Research Centre-SEREFO Laboratory, University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali., Diarra B; University Clinical Research Centre-SEREFO Laboratory, University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali., Ogunbosi B; Department of Paediatrics, College of Medicine, University of Ibadan and University College Hospital, Ibadan, Nigeria., Abok I; Department of Paediatrics, Jos University Teaching Hospital and University of Jos, Plateau State, Nigeria., Ebonyi AO; Department of Paediatrics, Jos University Teaching Hospital and University of Jos, Plateau State, Nigeria., Goka B; Department of Paediatrics and Child Health, Korle Bu Teaching Hospital and University of Ghana Medical School, Accra, Ghana., Affolabi D; National Teaching Hospital for Tuberculosis and Respiratory Diseases, Cotonou, Republic of Benin; National Tuberculosis Program, Republic of Benin., Oladokun R; Department of Paediatrics, College of Medicine, University of Ibadan and University College Hospital, Ibadan, Nigeria., Kehinde AO; Department of Medical Microbiology and Parasitology, College of Medicine, University of Ibadan and University College Hospital, Ibadan, Nigeria., Mohammed N; Medical Research Council Unit The Gambia at the London School of Hygiene and Tropical Medicine, Atlantic Road, Fajara, The Gambia., Togun T; Medical Research Council Unit The Gambia at the London School of Hygiene and Tropical Medicine, Atlantic Road, Fajara, The Gambia; Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom; TB Centre, London School of Hygiene and Tropical Medicine, London, United Kingdom. Electronic address: Toyin.Togun@lshtm.ac.uk.
Jazyk:	angličtina
Zdroj:	International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases [Int J Infect Dis] 2024 Mar; Vol. 140, pp. 86-91. Date of Electronic Publication: 2024 Jan 19.
DOI:	10.1016/j.ijid.2024.01.003
Abstrakt:	Objective: To evaluate the performance of Xpert Mycobacterium Tuberculosis/rifampicin (MTB/RIF) Ultra (Ultra) for diagnosis of childhood tuberculosis (TB) within public health systems. Methods: In this cross-sectional study, children aged <15 years with presumptive pulmonary TB were consecutively recruited and evaluated for TB at tertiary-level hospitals in Benin, Mali, and Ghana. Bivariate random-effects models were used to determine the pooled sensitivity and specificity of Ultra against culture. We also estimated its diagnostic yield against a composite microbiological reference standard (cMRS) of positive culture or Ultra. Results: Overall, 193 children were included in the analyses with a median (interquartile range) age of 4.0 (1.1-9.2) years, 88 (45.6%) were female, and 36 (18.7%) were HIV-positive. Thirty-one (16.1%) children had confirmed TB, 39 (20.2%) had unconfirmed TB, and 123 (63.7%) had unlikely TB. The pooled sensitivity and specificity of Ultra verified by culture were 55.0% (95% confidence interval [CI]: 28.0-79.0%) and 95.0% (95% CI: 88.0-98.0%), respectively. Against the cMRS, the diagnostic yield of Ultra and culture were 67.7% (95% CI: 48.6-83.3%) and 70.9% (95% CI: 51.9-85.8%), respectively. Conclusion: Ultra has suboptimal sensitivity in children with TB that were investigated under routine conditions in tertiary-level hospitals in three West African countries. Competing Interests: Declaration of competing interest None declared. (Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.)
Databáze:	MEDLINE
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