Observational studyThe Pediatric infectious disease journal2014
Use of Xpert for the diagnosis of pulmonary tuberculosis in severely malnourished hospitalized Malawian children.
Observational study in The Pediatric infectious disease journal, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers, 6 of them syntheses that pooled it.
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Who cites it
26 citing papers in PubMed, 6 syntheses or guidelines pooled it, 39 citations in OpenAlex.
- Paediatric tuberculosis diagnosis using Mycobacterium tuberculosis real-time polymerase chain reaction assay: a systematic review and meta-analysis.Systematic reviews · 2021Pooled it
- Screening tests for active pulmonary tuberculosis in children.The Cochrane database of systematic reviews · 2021Pooled it
- Xpert MTB/RIF and Xpert Ultra assays for screening for pulmonary tuberculosis and rifampicin resistance in adults, irrespective of signs or symptoms.The Cochrane database of systematic reviews · 2021Pooled it
- Which sample type is better for Xpert MTB/RIF to diagnose adult and pediatric pulmonary tuberculosis?Bioscience reports · 2020Pooled it
- Xpert MTB/RIF and Xpert MTB/RIF Ultra assays for active tuberculosis and rifampicin resistance in children.The Cochrane database of systematic reviews · 2020Pooled it
- Xpert MTB/RIF assay for the diagnosis of pulmonary tuberculosis in children: a systematic review and meta-analysis.The Lancet. Respiratory medicine · 2015Pooled it
- Tuberculosis prevalence among children with severe acute malnutrition: a systematic review and meta-analysis.medRxiv : the preprint server for health sciences · 2026Article
- Prevalence, radio-clinical patterns and factors associated with pulmonary tuberculosis among children with severe acute malnutrition: a cross-sectional study in Uganda.Journal of health, population, and nutrition · 2025Article
- The Spectrum of Pathogens Associated with Infections in African Children with Severe Acute Malnutrition: A Scoping Review.Tropical medicine and infectious disease · 2024Article
- Pulmonary Tuberculosis in Severely Malnourished Children Admitted to Nutrition Rehabilitation Centers: A Multicenter Study.Indian journal of pediatrics · 2024Article
- Development of tuberculosis treatment decision algorithms in children below 5 years hospitalised with severe acute malnutrition in Zambia and Uganda: a prospective diagnostic cohort study.EClinicalMedicine · 2024Article
- Tuberculosis in children with severe acute malnutrition.Expert review of respiratory medicine · 2022Review
- Detection of pulmonary tuberculosis in children using the Xpert MTB/RIF Ultra assay on sputum: a multicenter study.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2022Article
- HIV, Tuberculosis, and Food Insecurity in Africa-A Syndemics-Based Scoping Review.International journal of environmental research and public health · 2022Article
- Yield and Coverage of Active Case Finding Interventions for Tuberculosis Control:A Systematic Review and Meta-analysis.Tuberculosis research and treatment · 2022Review
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- Childhood Intra-Thoracic Tuberculosis Clinical Presentation Determines Yield of Laboratory Diagnostic Assays.Frontiers in pediatrics · 2021Article
- Article
- Bacteriological diagnosis of childhood TB: a prospective observational study.Scientific reports · 2017Observational
Corrections and comments
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Authors and funding
9 authors at 4 institutions in 2 countries.
Funding
Abstract
backgroundPulmonary tuberculosis contributes to increased morbidity and mortality in severely malnourished children in endemic settings. Despite high clinical suspicion, few tuberculosis prevalence estimates exist in malnourished African children. Diagnostics such as Xpert MTB/RIF may help to determine pulmonary tuberculosis prevalence, however its performance in severely malnourished children is largely unknown.
methodsWe conducted a prospective observational study evaluating Xpert compared to smear microscopy and liquid culture on induced sputums among severely malnourished children (aged 6 to 60 months) at Kamuzu Central Hospital in Lilongwe, Malawi. From February 1 to May 30, 2012, children who met World Health Organization 2006 guidelines for severe acute malnutrition were evaluated using clinical symptoms, tuberculin skin tests, chest radiographs, and induced sputums. National Institute of Health (NIH) consensus case definitions were used to estimate tuberculosis prevalence.
resultsThree hundred severely malnourished children (median age 18.5 months, IQR 12.1-25.6) had one induced sputum performed; 295 (98.3%) received two. Fifty-two (17.6%) were HIV-infected. Over 25% had tuberculosis exposure with 48/297 (16.2%) reporting contact and 40/287 (13.9%) with positive TST. Two (0.7%) patients had confirmed tuberculosis by Xpert and culture, but only one had positive smear microscopy. Twenty (6.7%) patients fulfilled probable and 97 (66%) met possible tuberculosis NIH case definitions. Overall mortality was 9.7%.
conclusionsMicrobiologic confirmation likely underestimates the prevalence of pulmonary tuberculosis in severely malnourished children. In our study, Xpert on induced sputums did not increase case finding. Future studies are needed using Xpert among targeted groups of severely malnourished children and on non-sputum specimens.
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