Ioos V. auteur aut IRD Cordel H. auteur aut IRD Bonnet Maryline auteur aut IRD text journalArticle eng text/pdf born digital access Background Diagnosis of intrathoracic tuberculosis (ITB) is limited in children partly by their difficulty to produce sputum specimen. Objective To systematically review the detection yields of mycobacterial culture and Xpert MTB/RIF from induced sputum (IS), nasopharyngeal aspirate (NPA) and gastric aspirate (GA) in children with presumptive ITB. Design Pubmed, Embase and Biosis databases and grey literature were searched. Randomised controlled trials, cohort, cross-sectional or case control studies using IS, GA and NPA for diagnosis of ITB published between January 1990 and January 2018 were included. Data were extracted on study design, case definition of presumptive ITB, sample collection methods, outcome measures and results. Results 30 studies were selected, including 11 554 children. Detection yields for culture ranged between 1% and 30% for IS, 1% and 45% for GA and 4% and 24% for NPA. For Xpert MTB/RIF, it was between 2% and 17% for IS, 5% and 51% for GA and 3% and 8% for NPA. There 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. Sampling a second specimen contributed for 6%-33% of the cumulative yield and combination of different methods significantly increase the detection yields. Conclusions Despite the important study heterogeneity, any of the specimen collection methods offers good potential to confirm childhood ITB. However, their operational challenges were poorly evaluated. In the absence of a sensitive non-sputum based test, only a minority of children with ITB can be confirmed. specialized 050 104 7 629-635 2019 0003-9888 https://www.documentation.ird.fr/hor/fdi:010076244 10.1136/archdischild-2018-315453 0003-9888 [F B010076244] https://www.documentation.ird.fr/hor/fdi:010076244 https://www.documentation.ird.fr/intranet/publi/2019/08/010076244.pdf Accès réservé (Intranet de l'IRD) IRD - Base Horizon / Pleins textes 2019-09-19 2025-02-24 fdi:010076244 fre