Evidence map›Paper›PMID 31670064›Full record

SynthesisTuberculosis (Edinburgh, Scotland)2019

Diagnostic accuracy of molecular detection of Mycobacterium tuberculosis in pediatric stool samples: A systematic review and meta-analysis.

Annelies W Mesman, Carly Rodriguez, Emily Ager, Julia Coit, Letizia Trevisi, Molly F Franke

Open access · hybridAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Tuberculosis (Edinburgh, Scotland), 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
24citing papers in PubMed, 5 pooled it
2.3field-weighted citation impact, top 11% 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

24 citing papers in PubMed, 5 syntheses or guidelines pooled it, 40 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Pooled it
  5. Pooled it
  6. Trial
  7. Article
  8. Article
  9. Article
  10. Review
  11. Article
  12. Article
  13. Article
  14. Article
  15. A critical perspective on paediatric pulmonary tuberculosis and diagnostic advancements.African journal of thoracic and critical care medicine · 2024
    Article
  16. Article
  17. Review
  18. Tuberculosis in Children.Infectious disease clinics of North America · 2022
    Review
  19. Review
  20. HIV-associated tuberculosis.International journal of STD & AIDS · 2021
    Article
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

6 authors at 2 institutions in 1 country.

Annelies W MesmanHarvard Medical School, Department of Global Health and Social Medicine, Boston, MA, USA.
Carly RodriguezHarvard Medical School, Department of Global Health and Social Medicine, Boston, MA, USA.
Emily AgerHarvard TH Chan School of Public Health, Department of Social and Behavioral Sciences, Boston, MA, USA.
Julia CoitHarvard Medical School, Department of Global Health and Social Medicine, Boston, MA, USA.
Letizia TrevisiHarvard Medical School, Department of Global Health and Social Medicine, Boston, MA, USA.
Molly F FrankeHarvard Medical School, Department of Global Health and Social Medicine, Boston, MA, USA. Electronic address: molly_franke@hms.harvard.edu.
Harvard University · USHarvard Global Health Institute · US

Funding

Sequencing CoreU19AI109755 · NIAID · HARVARD MEDICAL SCHOOL · PI CHANDLER, DARRELL P, CULHANE, AEDIN C · 2014 to 2018
$29.1M
NIAID NIH HHS HHSN272201700063CNIAID NIH HHS U19 AI109755
6 · The paper itself

Abstract

backgroundStool is a promising specimen option to diagnose pediatric tuberculosis (TB), but studies have reported a wide range of test sensitivities. We conducted a meta-analysis to assess the accuracy of Xpert MTB/RIF or 'in-house' molecular tests on stool samples against culture or Xpert MTB/RIF on respiratory samples or clinically-diagnosed unconfirmed TB and aimed to identify factors that contribute to the heterogeneity of reported sensitivity.

methodsWe searched EMBASE and Pubmed databases and conference abstract books for studies reporting molecular stool testing against a clinical or microbiological reference standard among children.

resultsWe identified 16 studies that included 2,481 children in stool test analyses. Pooled specificity was 98% [95%CI: 96-99], pooled sensitivity was 57% [95%CI: 40-72] against culture and 3% [95%CI: 2-6] among children with clinically-diagnosed, unconfirmed TB. There was much heterogeneity. Sensitivity was higher among children with a smear-positive sputum test. Rifampin resistance in stool was reported in two studies and detected in 5/14 children (36%).

conclusionOur results suggest molecular stool tests have potential as diagnostic rule-in tests, but it is challenging to optimize sensitivity due to between-study variation in methodology and test procedures. Therefore, we recommend future research with rigorous study design and standardized results reporting.

Indexed as

Drug Resistance, BacterialAntibiotics, AntitubercularChildFecesHumansMycobacterium tuberculosisReproducibility of ResultsTuberculosis, PulmonaryAntibiotics, AntitubercularAlternative sampleChildrenReviewStool test

Identifiers

PMID31670064
PMCPMC6914260
OpenAlexW2981765253

What OpenQuestion holds

Textmetadata
LicenceTDM
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.