Back to Search
Start Over
Diagnostic Accuracy of Stool Xpert MTB/RIF for Detection of Pulmonary Tuberculosis in Children: a Systematic Review and Meta-analysis
- Source :
- Journal of Clinical Microbiology
- Publication Year :
- 2019
- Publisher :
- American Society for Microbiology, 2019.
-
Abstract
- Invasive collection methods are often required to obtain samples for the microbiological evaluation of children with presumptive pulmonary tuberculosis (PTB). Nucleic acid amplification testing of easier-to-collect stool samples could be a noninvasive method of diagnosing PTB.<br />Invasive collection methods are often required to obtain samples for the microbiological evaluation of children with presumptive pulmonary tuberculosis (PTB). Nucleic acid amplification testing of easier-to-collect stool samples could be a noninvasive method of diagnosing PTB. We conducted a systematic review and meta-analysis to evaluate the diagnostic accuracy of testing stool with the Xpert MTB/RIF assay (“stool Xpert”) for childhood PTB. Four databases were searched for publications from January 2008 to June 2018. Studies assessing the diagnostic accuracy among children of stool Xpert compared to a microbiological reference standard of conventional specimens tested by mycobacterial culture or Xpert were eligible. Bivariate random-effects meta-analyses were performed to calculate pooled sensitivity and specificity of stool Xpert against the reference standard. From 1,589 citations, 9 studies (n = 1,681) were included. Median participant ages ranged from 1.3 to 10.6 years. Protocols for stool processing and testing varied substantially, with differences in reagents and methods of homogenization and filtering. Against the microbiological reference standard, the pooled sensitivity and specificity of stool Xpert were 67% (95% confidence interval [CI], 52 to 79%) and 99% (95% CI, 98 to 99%), respectively. Sensitivity was higher among children with HIV (79% [95% CI, 68 to 87%] versus 60% [95% CI, 44 to 74%] among HIV-uninfected children). Heterogeneity was high. Data were insufficient for subgroup analyses among children under the age of 5 years, the most relevant target population. Stool Xpert could be a noninvasive method of ruling in PTB in children, particularly those with HIV. However, studies focused on children under 5 years of age are needed, and generalizability of the evidence is limited by the lack of standardized stool preparation and testing protocols.
- Subjects :
- 0301 basic medicine
Microbiology (medical)
childhood TB
medicine.medical_specialty
Adolescent
Epidemiology
030106 microbiology
Human immunodeficiency virus (HIV)
Diagnostic accuracy
macromolecular substances
Microbial Sensitivity Tests
Target population
medicine.disease_cause
environment and public health
Sensitivity and Specificity
Feces
03 medical and health sciences
0302 clinical medicine
Reference Values
Pulmonary tuberculosis
Internal medicine
medicine
Humans
030212 general & internal medicine
stool
Child
Tuberculosis, Pulmonary
Reference standards
Collection methods
integumentary system
business.industry
Mycobacterial culture
Age Factors
Infant, Newborn
Infant
Reproducibility of Results
Mycobacterium tuberculosis
pediatric infectious disease
Child, Preschool
Meta-analysis
Rifampin
business
Nucleic Acid Amplification Techniques
Publication Bias
pulmonary tuberculosis
Xpert MTB/RIF assay
Subjects
Details
- ISSN :
- 1098660X and 00951137
- Volume :
- 57
- Database :
- OpenAIRE
- Journal :
- Journal of Clinical Microbiology
- Accession number :
- edsair.doi.dedup.....df95f64d64af84f7d840e0a2f5d8be26