@article{fdi:010083945,
  title = {{T}uberculosis diagnostic accuracy of stool {X}pert {MTB}/{RIF} and urine {A}lere{LAM} in vulnerable children},
  author = {{O}rikiriza, {P}. and {S}mith, {J}. and {S}sekyanzi, {B}. and {N}yehangane, {D}. and {T}aremwa, {I}. {M}. and {T}uryashemererwa, {E}. and {B}yamukama, {O}. and {T}usabe, {T}. and {A}rdizzoni, {E}. and {M}arais, {B}. and {W}obudeya, {E}. and {K}emigisha, {E}. and {M}wanga-{A}mumpaire, {J}. and {N}ampijja, {D}. and {B}onnet, {M}aryline},
  editor = {},
  language = {{ENG}},
  abstract = {{B}ackground {N}on-sputum-based diagnostic approaches are crucial in children at high risk of disseminated tuberculosis ({TB}) who cannot expectorate sputum. {W}e evaluated the diagnostic accuracy of stool {X}pert {MTB}/{RIF} and urine {A}lere{LAM} tests in this group of children. {M}ethods {H}ospitalised children with presumptive {TB} and either age <2 years, {HIV}-positive or with severe malnutrition were enrolled in a diagnostic cohort. {A}t enrolment, we attempted to collect two urine, two stool and two respiratory samples. {U}rine and stool were tested with {A}lere{LAM} and {X}pert {MTB}/{RIF}, respectively. {R}espiratory samples were tested with {X}pert {MTB}/{RIF} and mycobacterial culture. {B}oth a microbiological and a composite clinical reference standard were used. {R}esults {T}he study analysed 219 children; median age 16.4 months, 72 (32.9%) {HIV}-positive and 184 (84.4%) severely malnourished. 12 (5.5%) and 58 (28.5%) children had confirmed and unconfirmed {TB}, respectively. {S}tool and urine were collected in 21,9 (100%) and 216 (98.6%) children, respectively. {A}gainst the microbiological reference standard, the sensitivity and specificity of stool {X}pert {MTB}/{RIF} was 50.0% (6/12, 95% {CI} 21.1-78.9%) and 99.1% (198/200, 95% 96.4-99.9%), while that of urine {A}lere{LAM} was 50.0% (6/12, 95% 21.1-78.9%) and 74.6% (147/197, 95% 67.9-80.5%), respectively. {A}gainst the composite reference standard, sensitivity was reduced to 11.4% (8/70) for stool and 26.2% (17/68) for urine, with no major difference by age group (<2 and >= 2 years) or {HIV} status. {C}onclusions {T}he {X}pert {MTB}/{RIF} assay has excellent specificity on stool, but sensitivity is suboptimal. {U}rine {AI}ere{LAM} is compromised by poor sensitivity and specificity in children.},
  keywords = {{OUGANDA}},
  booktitle = {},
  journal = {{E}uropean {R}espiratory {J}ournal},
  volume = {59},
  numero = {1},
  pages = {2101116 [12 ]},
  ISSN = {0903-1936},
  year = {2022},
  DOI = {10.1183/13993003.01116-2021},
  URL = {https://www.documentation.ird.fr/hor/fdi:010083945},
}