Evidence map›Paper›PMID 22752518›Full record

ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2012

Rapid molecular diagnosis of pulmonary tuberculosis in children using nasopharyngeal specimens.

Heather J Zar, Lesley Workman, Washiefa Isaacs, Jacinta Munro, Faye Black, Brian Eley, Veronica Allen, Catharina C Boehme, Widaad Zemanay, Mark P Nicol

Open access · bronzeAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 84 papers, 16 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
84citing papers in PubMed, 16 pooled it
9.1field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

84 citing papers in PubMed, 16 syntheses or guidelines pooled it, 167 citations in OpenAlex.

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  6. The association between bacteria colonizing the upper respiratory tract and lower respiratory tract infection in young children: a systematic review and meta-analysis.Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases · 2021
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  7. Screening tests for active pulmonary tuberculosis in children.The Cochrane database of systematic reviews · 2021
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24 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 5 institutions in 2 countries.

Heather J ZarDepartment of Paediatrics and Child Health, University of Cape Town, South Africa. heather.zar@uct.ac.za
Lesley Workman
Washiefa Isaacs
Jacinta Munro
Faye Black
Brian Eley
Veronica Allen
Catharina C Boehme
Widaad Zemanay
Mark P Nicol
University of Cape Town · ZARed Cross War Memorial Children's Hospital · ZAFoundation for Innovative New Diagnostics · CHGroote Schuur Hospital · ZANational Health Laboratory Service · ZA

Funding

Diagnosis of Tuberculosis in HIV-infected children & development of microbiologicR01HD058971 · NICHD · UNIVERSITY OF CAPE TOWN · PI ZAR, HEATHER JOY · 2008 to 2012
$2.2M
NICHD NIH HHS 1R01HD058971-01NICHD NIH HHS R01 HD058971Wellcome TrustWellcome Trust 085251/B/08/Z
6 · The paper itself

Abstract

backgroundA rapid diagnosis of pediatric pulmonary tuberculosis (PTB) using Xpert MTB/RIF (Mycobacterium tuberculosis/rifampicin) automated testing on induced sputum (IS) is possible, but the capacity for performing IS is limited. The diagnosis using a nasopharyngeal aspirate (NPA), which can be non-invasively obtained, is desirable.

methodsPaired specimens (NPA and IS) were tested using smear, liquid culture and Xpert. The diagnostic accuracy of Xpert and smear was compared with culture for different specimens in children with suspected PTB.

resultsThere were 535 children [median age 19 months, 117 (21·9%) HIV-infected] who had one IS and one NPA specimen; 396 had two paired specimens. A positive smear, Xpert test or culture occurred in 30 (5.6%), 81 (15.1%) and 87 children (16.3%), respectively. The culture yield was higher from IS (84/87, 96.6%) vs NPA (61/87, 70.1%, P < .001). Amongst children with two paired specimens, 63 culture-confirmed cases occurred [60 (95.2%) IS vs 48 (76.2%) NPA, P = .002]. The sensitivity of two Xpert tests was similar for IS and NPAs [(45/63) 71% vs (41/63) 65%, P = .444)]; the sensitivity of smear was lower for IS (21/63, 33%) and NPA (16/63, 25%). The incremental yield from a second IS was 9 cases (17.6%) by culture and 9 (25%) by Xpert testing; a second NPA increased the culture yield by 10 (26.3%) and Xpert by 11 (36.7%). Xpert specificity was 99.1% (98.1-100) for IS and 98.2% (96.8-99.6) for NPAs. Xpert testing provided faster results than culture (median 0 vs 15 days, P < .001).

conclusionsXpert testing on 2 NPAs is useful in children with suspected PTB, particularly in settings where IS and culture are not feasible.

Indexed as

Bacteriological TechniquesChild, PreschoolFemaleHumansInfantMaleMolecular Diagnostic TechniquesMycobacterium tuberculosisNasopharynxSensitivity and SpecificitySputumTuberculosis, Pulmonary

Identifiers

PMID22752518
PMCPMC3529610
OpenAlexW2102332285

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.