%0 Journal Article
%9 ACL : Articles dans des revues avec comité de lecture répertoriées par l'AERES
%A Orikiriza, P.
%A Nansumba, M.
%A Nyehangane, D.
%A Bastard, M.
%A Mugisha, I. T.
%A Nansera, D.
%A Mwanga-Amumpaire, J.
%A Boum, Y.
%A Kumbakumba, E.
%A Bonnet, Maryline
%T Xpert MTB/RIF diagnosis of childhood tuberculosis from sputum and stool samples in a high TB-HIV-prevalent setting
%D 2018
%L fdi:010073608
%G ENG
%J European Journal of Clinical Microbiology and Infectious Diseases
%@ 0934-9723
%K Childhood tuberculosis ; Stool ; Sputum ; XpertMTB/RIF
%K OUGANDA
%M ISI:000438095700010
%N 8
%P 1465-1473
%R 10.1007/s10096-018-3272-0
%U https://www.documentation.ird.fr/hor/fdi:010073608
%> https://www.documentation.ird.fr/intranet/publi/2018/07/010073608.pdf
%V 37
%W Horizon (IRD)
%X The Xpert MTB/RIF assay is a major advance for diagnosis of tuberculosis (TB) in high-burden countries but is limited in children by their difficulty to produce sputum. We investigated TB in sputum and stool from children with the aim of improving paediatric TB diagnosis. A prospective cohort of children with presumptive TB, provided two sputum or induced sputum at enrolment in a regional referral hospital in Uganda. Stool was collected from those started on TB treatment. All specimen were tested for Xpert MTB/RIF, mycobacteria growth indicator tube (MGIT), Lowenstein Jensen cultures and microscopy (except stool). We compared TB detection between age categories and assessed the performance of Xpert MTB/RIF in sputum and stool. Of the 392 children enrolled, 357 (91.1%) produced at least one sputum sample. Sputum culture yield was 13/357 (3.6%): 3/109 (2.6%), 3/89 (3.2%), 3/101 (2.6%) and 4/44 (8.2%) among children of < 2, 2-5, ae<yen> 5-10 and > 10 years, respectively (p = 0.599). Xpert MTB/RIF yield was 14/350 (4.0%): 3/104 (2.9%), 4/92 (4.3%), 3/88 (2.9%) and 4/50 (.0%), respectively (p = 0.283). Sensitivity and specificity of Xpert MTB/RIF in sputum against sputum culture were 90.9% (95% CI 58.7-99.8) and 99.1% (99.1-99.8). In stool, it was 55.6% (21.2-86.3) and 98.2% (98.2-100) against Xpert MTB/RIF and culture in sputum. Only a minority of children had microbiologically confirmed TB with a higher proportion in children above 10 years. Although sensitivity of Xpert MTB/RIF in stool was low, with good optimization, it might be a good alternative to sputum in children.
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