Evidence map›Paper›PMID 35579497›Full record

ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2022

Oral Swab Specimens Tested With Xpert MTB/RIF Ultra Assay for Diagnosis of Pulmonary Tuberculosis in Children: A Diagnostic Accuracy Study.

Helen Cox, Lesley Workman, Lindy Bateman, Zoe Franckling-Smith, Margaretha Prins, Juaneta Luiz, Judi Van Heerden, Lemese Ah Tow Edries, Samantha Africa, Veronica Allen and 4 more

Open access · greenAbstract 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, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 34 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
34citing papers in PubMed, 4 pooled it
4.3field-weighted citation impact, top 4% 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

34 citing papers in PubMed, 4 syntheses or guidelines pooled it, 47 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Pooled it
  5. Diagnostic Accuracy of Molecular Testing on Saliva and Oral Swabs for Pulmonary Tuberculosis.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2026
    Article
  6. Review
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  8. Article
  9. Article
  10. Oral Rinse as an Alternative Diagnostic Specimen for Detection of Tuberculosis.American journal of respiratory and critical care medicine · 2025
    Article
  11. Article
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  16. High-sensitivity detection ofJournal of clinical microbiology · 2025
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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

14 authors at 4 institutions in 2 countries.

Helen CoxDivision of Medical Microbiology, Department of Pathology, University of Cape Town, Cape Town, South Africa.
Lesley WorkmanDepartment of Paediatrics and Child Health and South African Medical Research Council Unit on Child and Adolescent Health, University of Cape Town and Red Cross War Memorial Children's Hospital, Cape Town, South Africa.
Lindy BatemanDepartment of Paediatrics and Child Health and South African Medical Research Council Unit on Child and Adolescent Health, University of Cape Town and Red Cross War Memorial Children's Hospital, Cape Town, South Africa.
Zoe Franckling-SmithDepartment of Paediatrics and Child Health and South African Medical Research Council Unit on Child and Adolescent Health, University of Cape Town and Red Cross War Memorial Children's Hospital, Cape Town, South Africa.
Margaretha PrinsDepartment of Paediatrics and Child Health and South African Medical Research Council Unit on Child and Adolescent Health, University of Cape Town and Red Cross War Memorial Children's Hospital, Cape Town, South Africa.
Juaneta LuizDepartment of Paediatrics and Child Health and South African Medical Research Council Unit on Child and Adolescent Health, University of Cape Town and Red Cross War Memorial Children's Hospital, Cape Town, South Africa.
Judi Van HeerdenDivision of Medical Microbiology, Department of Pathology, University of Cape Town, Cape Town, South Africa.
Lemese Ah Tow EdriesDivision of Medical Microbiology, Department of Pathology, University of Cape Town, Cape Town, South Africa.
Samantha AfricaDivision of Medical Microbiology, Department of Pathology, University of Cape Town, Cape Town, South Africa.
Veronica AllenDivision of Medical Microbiology, Department of Pathology, University of Cape Town, Cape Town, South Africa.
Cynthia BaardDepartment of Paediatrics and Child Health and South African Medical Research Council Unit on Child and Adolescent Health, University of Cape Town and Red Cross War Memorial Children's Hospital, Cape Town, South Africa.
Widaad ZemanayDivision of Medical Microbiology, Department of Pathology, University of Cape Town, Cape Town, South Africa.
Mark P NicolDivision of Medical Microbiology, Department of Pathology, University of Cape Town, Cape Town, South Africa.
Heather J ZarDepartment of Paediatrics and Child Health and South African Medical Research Council Unit on Child and Adolescent Health, University of Cape Town and Red Cross War Memorial Children's Hospital, Cape Town, South Africa.
University of Cape Town · ZASouth African Medical Research Council · ZARed Cross War Memorial Children's Hospital · ZAUniversity of Western Australia · AU

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
NIH HHS RO1HD058971
6 · The paper itself

Abstract

backgroundMicrobiologic diagnosis of childhood tuberculosis may be difficult. Oral swab specimens are a potential noninvasive alternative to sputum specimens for diagnosis.

methodsThis was a prospective diagnostic accuracy study of oral swab specimens (buccal and tongue) for pulmonary tuberculosis diagnosis in children (aged ≤ 15 years) in 2 South African hospital sites. Children with cough of any duration as well as a positive tuberculin skin test result, tuberculosis contact, loss of weight, or chest radiograph suggestive of pulmonary tuberculosis were enrolled. Two induced sputum specimens were tested with Xpert MTB/RIF (or Xpert MTB/RIF Ultra) assay and liquid culture. Oral swab specimens were obtained before sputum specimens, frozen, and later tested with Xpert MTB/RIF Ultra. Children were classified as microbiologically confirmed tuberculosis, unconfirmed tuberculosis (receipt of tuberculosis treatment), or unlikely tuberculosis according to National Institutes of Health consensus definitions based on sputum microbiologic results.

resultsAmong 291 participants (median age [interquartile range], 32 [14-73] months), 57 (20%) had human immunodeficiency virus (HIV), and 87 (30%) were malnourished; 90 (31%) had confirmed pulmonary tuberculosis (rifampicin resistant in 6 [7%] ), 157 (54%), unconfirmed pulmonary tuberculosis, and 44 (15%), unlikely tuberculosis. A single oral swab specimen was obtained from 126 (43%) of the participants (tongue in 96 and buccal in 30) and 2 swab specimens from 165 (57%) (tongue in 110 and buccal in 55). Sensitivity was low (22% [95% confidence interval, 15%-32%]) for all swab specimens combined (with confirmed pulmonary tuberculosis as reference), but specificity was high (100% [91%-100%]). The highest sensitivity was 33% (95% confidence interval, 15%-58%) among participants with HIV. The overall yield was 6.9% with 1 oral swab specimen and 7.2% with 2.

conclusionsUse of the Xpert MTB/RIF Ultra assay with oral swab specimens provides poor yield for microbiologic pulmonary tuberculosis confirmation in children.

Indexed as

HIV InfectionsMycobacterium tuberculosisTuberculosisTuberculosis, PulmonaryChildChild, PreschoolHumansProspective StudiesRifampinSensitivity and SpecificitySputumRifampinchildrenoral swab specimenpulmonarytuberculosisXpert MTB/RIF Ultra

Identifiers

PMID35579497
PMCPMC9761885
OpenAlexW4280538803

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
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.