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Diagnostic accuracy of molecular detection of Mycobacterium tuberculosis in pediatric stool samples: A systematic review and meta-analysis.
- Source :
-
Tuberculosis (Edinburgh, Scotland) [Tuberculosis (Edinb)] 2019 Dec; Vol. 119, pp. 101878. Date of Electronic Publication: 2019 Oct 23. - Publication Year :
- 2019
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Abstract
- Background: Stool 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.<br />Methods: We searched EMBASE and Pubmed databases and conference abstract books for studies reporting molecular stool testing against a clinical or microbiological reference standard among children.<br />Results: We 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%).<br />Conclusion: Our 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.<br /> (Copyright © 2019 The Authors. Published by Elsevier Ltd.. All rights reserved.)
Details
- Language :
- English
- ISSN :
- 1873-281X
- Volume :
- 119
- Database :
- MEDLINE
- Journal :
- Tuberculosis (Edinburgh, Scotland)
- Publication Type :
- Academic Journal
- Accession number :
- 31670064
- Full Text :
- https://doi.org/10.1016/j.tube.2019.101878