@article{fdi:010076244,
  title = {{A}lternative sputum collection methods for diagnosis of childhood intrathoracic tuberculosis : a systematic literature review},
  author = {{I}oos, {V}. and {C}ordel, {H}. and {B}onnet, {M}aryline},
  editor = {},
  language = {{ENG}},
  abstract = {{B}ackground {D}iagnosis of intrathoracic tuberculosis ({ITB}) is limited in children partly by their difficulty to produce sputum specimen. {O}bjective {T}o systematically review the detection yields of mycobacterial culture and {X}pert {MTB}/{RIF} from induced sputum ({IS}), nasopharyngeal aspirate ({NPA}) and gastric aspirate ({GA}) in children with presumptive {ITB}. {D}esign {P}ubmed, {E}mbase and {B}iosis databases and grey literature were searched. {R}andomised controlled trials, cohort, cross-sectional or case control studies using {IS}, {GA} and {NPA} for diagnosis of {ITB} published between {J}anuary 1990 and {J}anuary 2018 were included. {D}ata were extracted on study design, case definition of presumptive {ITB}, sample collection methods, outcome measures and results. {R}esults 30 studies were selected, including 11 554 children. {D}etection yields for culture ranged between 1% and 30% for {IS}, 1% and 45% for {GA} and 4% and 24% for {NPA}. {F}or {X}pert {MTB}/{RIF}, it was between 2% and 17% for {IS}, 5% and 51% for {GA} and 3% and 8% for {NPA}. {T}here was a tendency of better yields with {IS} when the pretest probability of {ITB} was low to moderate and with {GA} when it was high. {S}ampling a second specimen contributed for 6%-33% of the cumulative yield and combination of different methods significantly increase the detection yields. {C}onclusions {D}espite the important study heterogeneity, any of the specimen collection methods offers good potential to confirm childhood {ITB}. {H}owever, their operational challenges were poorly evaluated. {I}n the absence of a sensitive non-sputum based test, only a minority of children with {ITB} can be confirmed.},
  keywords = {},
  booktitle = {},
  journal = {{A}rchives of {D}isease in {C}hildhood},
  volume = {104},
  numero = {7},
  pages = {629--635},
  ISSN = {0003-9888},
  year = {2019},
  DOI = {10.1136/archdischild-2018-315453},
  URL = {https://www.documentation.ird.fr/hor/fdi:010076244},
}