ArticleJournal of the Pediatric Infectious Diseases Society2025
Performance of a Novel Stool Quantitative Polymerase Chain Reaction Assay for Pediatric Tuberculosis Detection in Sub-Saharan Africa.
Article in Journal of the Pediatric Infectious Diseases Society, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- Clinical Evaluation of a Stool-Based Molecular Point-of-Care Test Kit for Noninvasive Detection of Helicobacter pylori Infection and Clarithromycin Resistance.Canadian journal of gastroenterology & hepatology · 2026Article
- A Year in Review on Tuberculosis and Non-tuberculous Mycobacteria Disease: A 2026 Update for Clinicians and Scientists.Pathogens & immunity · 2026Review
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Authors and funding
21 authors.
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Abstract
backgroundChildren have paucibacillary tuberculosis and cannot provide expectorated sputum. Invasive specimen collection, by gastric aspiration or sputum induction, has a low diagnostic yield. In this study, we aimed to evaluate the diagnostic performance and additive yield of a novel stool-based assay in children diagnosed with tuberculosis in sub-Saharan Africa.
methodsWe conducted a prospective case-control study from October 2020 to June 2023 in Eswatini, Mozambique, and Tanzania. Children under 15 years newly diagnosed with tuberculosis completed clinical examination, chest radiography, culture, sputum Xpert Ultra, stool Xpert Ultra, and stool-based quantitative polymerase chain reaction (stool qPCR) assessment. Stool qPCR sensitivity was calculated against culture, a composite microbiological reference standard, and a clinical reference standard. Specificity was calculated in a control population of healthy, TB disease-free, child household contacts.
resultsAmong 456 children, 232 were diagnosed with TB and 224 controls. Stool sample collection was achieved in 95.6% of children. The qPCR was positive in 17.2% (40/232) of clinically diagnosed participants. In the same population, test positivity was 8% (13/162) for culture, 13.4% (27/202) sputum Xpert Ultra, and 14.8% (33/223) stool Xpert Ultra. When compared to a microbiological reference standard (any positive test), the sensitivity of stool qPCR was 35.6% (21/59). Specificity in the control population was 96.1% (196/204), and the additive yield of qPCR with all tests performed was of 8.7%.
conclusionThis stool qPCR assay can increase the microbiologic confirmation of tuberculosis in pediatric populations from TB high-burden settings. It may be particularly useful where resource limitations or clinical capacity impedes diagnostic specimen collection via sputum induction or gastric aspiration.
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