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Lessons Learned from Early Implementation and Scale-up of Stool-Based Xpert Testing to Diagnose Tuberculosis in Children

Klinkenberg, Eveline ; de Haas, Petra ; Manyonge, Charles ; Namutebi, Joanita ; Mujangi, Bibiche ; Mutunzi, Hebert ; Kingalu, Amri ; Nwokoye, Nkiru ; Mbendera, Kuzani and Babo, Yohannes D , et al. (2025) In Emerging Infectious Diseases 31(3). p.1-9
Abstract

In 2020, fecal (stool) testing was recommended for diagnosing Mycobacterium tuberculosis complex (MTBC) infection in children by using the Cepheid Xpert MTB/RIF assay; since then, countries have begun implementing stool-based testing, often as part of a comprehensive strategy to enhance TB case finding among children. On the basis of an experience-sharing workshop in November 2023, we determined insights of 9 early-adopter countries. Across those countries, 71,757 children underwent stool testing over a combined period of 121 months, October 2020-September 2023. A total of 2,892 children were positive for MTBC, and rifampin resistance was confirmed for 43 stool samples. The overall yield of MTBC detection across the countries was 4.1%... (More)

In 2020, fecal (stool) testing was recommended for diagnosing Mycobacterium tuberculosis complex (MTBC) infection in children by using the Cepheid Xpert MTB/RIF assay; since then, countries have begun implementing stool-based testing, often as part of a comprehensive strategy to enhance TB case finding among children. On the basis of an experience-sharing workshop in November 2023, we determined insights of 9 early-adopter countries. Across those countries, 71,757 children underwent stool testing over a combined period of 121 months, October 2020-September 2023. A total of 2,892 children were positive for MTBC, and rifampin resistance was confirmed for 43 stool samples. The overall yield of MTBC detection across the countries was 4.1% (range 1.1%-17.3%). Stool collection for Xpert testing was considered noninvasive and as easy as sputum testing. Stool-based testing can be integrated into peripheral healthcare levels as a routine test to increase bacteriologic confirmation among children with presumptive TB.

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publishing date
type
Contribution to journal
publication status
published
subject
keywords
Humans, Feces/microbiology, Child, Mycobacterium tuberculosis/genetics, Tuberculosis/diagnosis, Child, Preschool, Molecular Diagnostic Techniques/methods, Infant, Female, Adolescent, Male
in
Emerging Infectious Diseases
volume
31
issue
3
pages
1 - 9
publisher
Centers for Disease Control and Prevention (CDC)
external identifiers
  • pmid:40023826
  • scopus:86000193141
ISSN
1080-6040
DOI
10.3201/eid3103.241580
language
English
LU publication?
no
id
55c71d18-58fa-4d26-97db-28b391bd8d7b
date added to LUP
2025-03-12 14:50:32
date last changed
2025-06-02 04:20:27
@article{55c71d18-58fa-4d26-97db-28b391bd8d7b,
  abstract     = {{<p>In 2020, fecal (stool) testing was recommended for diagnosing Mycobacterium tuberculosis complex (MTBC) infection in children by using the Cepheid Xpert MTB/RIF assay; since then, countries have begun implementing stool-based testing, often as part of a comprehensive strategy to enhance TB case finding among children. On the basis of an experience-sharing workshop in November 2023, we determined insights of 9 early-adopter countries. Across those countries, 71,757 children underwent stool testing over a combined period of 121 months, October 2020-September 2023. A total of 2,892 children were positive for MTBC, and rifampin resistance was confirmed for 43 stool samples. The overall yield of MTBC detection across the countries was 4.1% (range 1.1%-17.3%). Stool collection for Xpert testing was considered noninvasive and as easy as sputum testing. Stool-based testing can be integrated into peripheral healthcare levels as a routine test to increase bacteriologic confirmation among children with presumptive TB.</p>}},
  author       = {{Klinkenberg, Eveline and de Haas, Petra and Manyonge, Charles and Namutebi, Joanita and Mujangi, Bibiche and Mutunzi, Hebert and Kingalu, Amri and Nwokoye, Nkiru and Mbendera, Kuzani and Babo, Yohannes D and Kalmambetova, Gulmira and Dravniece, Gunta and Mwanza, Winnie and Bedru, Ahmed and Jerene, Degu D and Adams, Lisa V and Mwansasu, Andwele and Colvin, Charlotte}},
  issn         = {{1080-6040}},
  keywords     = {{Humans; Feces/microbiology; Child; Mycobacterium tuberculosis/genetics; Tuberculosis/diagnosis; Child, Preschool; Molecular Diagnostic Techniques/methods; Infant; Female; Adolescent; Male}},
  language     = {{eng}},
  number       = {{3}},
  pages        = {{1--9}},
  publisher    = {{Centers for Disease Control and Prevention (CDC)}},
  series       = {{Emerging Infectious Diseases}},
  title        = {{Lessons Learned from Early Implementation and Scale-up of Stool-Based Xpert Testing to Diagnose Tuberculosis in Children}},
  url          = {{http://dx.doi.org/10.3201/eid3103.241580}},
  doi          = {{10.3201/eid3103.241580}},
  volume       = {{31}},
  year         = {{2025}},
}