A multicountry evaluation of the Xpert MTB/RIF assay for the diagnosis of intrathoracic tuberculosis in children using alternative specimens (nasopharyngeal aspirate and stool): A prospective cohort study conducted in Madagascar, Ivory Coast and Cameroon (TB Kids project).

Autor:	Randremanana RV; Institut Pasteur de Madagascar, Antananarivo, Madagascar. Electronic address: rrandrem@pasteur.mg., Tejiokem M; Centre Pasteur du Cameroun, Yaoundé, Cameroun., Rakotosamimanana N; Institut Pasteur de Madagascar, Antananarivo, Madagascar., Donfack VD; Centre Pasteur du Cameroun, Yaoundé, Cameroun., Mbouchong VB; Centre Pasteur du Cameroun, Yaoundé, Cameroun., Randrianarisoa M; Institut Pasteur de Madagascar, Antananarivo, Madagascar., Harimanana A; Institut Pasteur de Madagascar, Antananarivo, Madagascar., Taguebue JV; Centre Mère et Enfant de la Fondation Chantal Biya, Yaoundé, Cameroun., Ndiang ST; Centre Hospitalier d'Essos, Yaoundé, Cameroun., Itchy V; Service de Pédiatrie, Centre Hospitalier Universitaire de Cocody, Abidjan, Côte d'Ivoire., Robinson A; Centre Hospitalier Universitaire Mère Enfant Tsaralalana, Antananarivo, Madagascar., Ravelomanana L; Centre Hospitalier Universitaire Mère Enfant Ambohimiandra, Antananarivo, Madagascar., Rakotomahefa M; Service de pédiatrie, Centre Hospitalier Universitaire Joseph Raseta Befelatanana, Antananarivo, Madagascar., Ranoharison D; Service d'imagerie médicale, Centre Hospitalier Universitaire Andohatapenaka, Antananarivo, Madagascar., Soumahoro MK; Institut Pasteur de Côte d'Ivoire, Abidjan, Côte d'Ivoire., Gicquel B; Institut Pasteur, Paris, France., N'Guessan R; Institut Pasteur de Côte d'Ivoire, Abidjan, Côte d'Ivoire., Eyangoh S; Centre Pasteur du Cameroun, Yaoundé, Cameroun., Rasolofo V; Institut Pasteur de Madagascar, Antananarivo, Madagascar., Irie MIB; Institut Pasteur de Côte d'Ivoire, Abidjan, Côte d'Ivoire., Bai-Orsot A; Institut Pasteur de Côte d'Ivoire, Abidjan, Côte d'Ivoire., Septoh JFY; Centre Pasteur du Cameroun, Yaoundé, Cameroun., Abogo S; Centre Hospitalier d'Essos, Yaoundé, Cameroun., Raherison MS; Institut Pasteur de Madagascar, Antananarivo, Madagascar., Rakotoson A; Institut Pasteur de Madagascar, Antananarivo, Madagascar., Raharimanga V; Institut Pasteur de Madagascar, Antananarivo, Madagascar., Piola P; Institut Pasteur de Madagascar, Antananarivo, Madagascar., Ranaivomanana P; Institut Pasteur de Madagascar, Antananarivo, Madagascar., Collard JM; Institut Pasteur de Madagascar, Antananarivo, Madagascar; Institut Pasteur, Paris, France., Andrianah GPE; Service d'imagerie médicale, Centre Hospitalier Universitaire Andohatapenaka, Antananarivo, Madagascar., Razafindranaivo T; Programme National Tuberculose, Ministère de la Santé Publique, Madagascar., Mangahasimbola RT; Institut Pasteur de Madagascar, Antananarivo, Madagascar., Victoir K; Institut Pasteur, Paris, France.
Jazyk:	angličtina
Zdroj:	International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases [Int J Infect Dis] 2024 Dec 16, pp. 107366. Date of Electronic Publication: 2024 Dec 16.
DOI:	10.1016/j.ijid.2024.107366
Abstrakt:	Context: Tuberculosis (TB) diagnosis in children remains challenging due to the paucibacillary nature of specimens and the difficulty in obtaining suitable samples. The use of alternative samples like nasopharyngeal aspirate (NPA) and stools, alongside Xpert MTB/RIF testing, offers promising improvements. Objective: This study aimed to assess the diagnostic performance of the Xpert MTB/RIF test on NPA and stool samples for detecting intrathoracic TB in children from Madagascar, Cameroon, and Ivory Coast. Methods: Children under 15 years with suspected intrathoracic TB were enrolled in hospitals in these countries' capitals. Samples for analysis included standard specimens (gastric aspirate or sputum), NPA, stools, with additional HIV serology, TST tests, and chest X-rays. We used a composite reference standard to estimate the accuracy of the Xpert MTB/RIF test with alternative samples. Results: Of 1146 children analysed, the sensitivity of Xpert MTB/RIF was 58.3% for NPA and 45.5% for stool samples, with high specificity more than 95%. The diagnostic performance of Xpert MTB/RIF with alternative samples did not differ according to age group or to HIV status. Conclusion: The findings support the WHO's 2022 recommendation for using Xpert MTB/RIF with alternative samples in childhood TB diagnosis, underscoring its utility across different settings and HIV statuses. Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. (Copyright © 2024. Published by Elsevier Ltd.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu