@article{fdi:010066924,
  title = {{P}erformance of {X}pert {MTB}/{RIF} and alternative specimen collection methods for the diagnosis of tuberculosis in {HIV}-infected children},
  author = {{M}arcy, {O}. and {U}ng, {V}. and {G}oyet, {S}. and {B}orand, {L}. and {M}sellati, {P}hilippe and {T}ejiokem, {M}. and {T}hi, {N}. {L}. {N}. and {N}acro, {B}. and {C}heng, {S}. and {E}yangoh, {S}. and {P}ham, {T}. {H}. and {O}uedraogo, {A}. {S}. and {T}arantola, {A}. and {G}odreuil, {S}. and {B}lanche, {S}. and {D}elacourt, {C}.},
  editor = {},
  language = {{ENG}},
  abstract = {{B}ackground. {T}he diagnosis of tuberculosis in human immunodeficiency virus ({HIV})-infected children is challenging. {W}e assessed the performance of alternative specimen collection methods for tuberculosis diagnosis in {HIV}-infected children using {X}pert {MTB}/{RIF} ({X}pert). {M}ethods. {HIV}-infected children aged <= 13 years with suspected intrathoracic tuberculosis were enrolled in 8 hospitals in {B}urkina {F}aso, {C}ambodia, {C}ameroon, and {V}ietnam. {G}astric aspirates were taken for children aged < 10 years and expectorated sputum samples were taken for children aged >= 10 years (standard samples); nasopharyngeal aspirate and stool were taken for all children, and a string test was performed if the child was aged >= 4 years (alternative samples). {A}ll samples were tested with {X}pert. {T}he diagnostic accuracy of {X}pert for culture-confirmed tuberculosis was analyzed in intention-to-diagnose and per-protocol approaches. {R}esults. {O}f 281 children enrolled, 272 (96.8%) had >= 1 specimen tested with {X}pert (intention-to-diagnose population), and 179 (63.5%) had all samples tested with {X}pert (per-protocol population). {T}uberculosis was culture-confirmed in 29/272 (10.7%) children. {I}ntention-to-diagnose sensitivities of {X}pert performed on all, standard, and alternative samples were 79.3% (95% confidence interval [{CI}], 60.3-92.0), 72.4% (95% {CI}, 52.8-87.3), and 75.9% (95% {CI}, 56.5-89.7), respectively. {S}pecificities were >= 97.5%. {X}pert combined on nasopharyngeal aspirate and stool had intention-to-diagnose and per-protocol sensitivities of 75.9% (95% {CI}, 56.5-89.7) and 75.0% (95% {CI}, 47.6-92.7), respectively. {C}onclusions. {T}he combination of nasopharyngeal aspirate and stool sample is a promising alternative to methods usually recommended by national programs. {X}pert performed on respiratory and stools samples enables rapid confirmation of tuberculosis diagnosis in {HIV}-infected children.},
  keywords = {tuberculosis ; children ; {HIV} infection ; diagnosis ; {X}pert {MTB}/{RIF} ; {BURKINA} {FASO} ; {CAMBODGE} ; {CAMEROUN} ; {VIET} {NAM}},
  booktitle = {},
  journal = {{C}linical {I}nfectious {D}iseases},
  volume = {62},
  numero = {9},
  pages = {1161--1168},
  ISSN = {1058-4838},
  year = {2016},
  DOI = {10.1093/cid/ciw036},
  URL = {https://www.documentation.ird.fr/hor/fdi:010066924},
}