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dc.rights.licenseopenen_US
dc.contributor.authorCARRATALA-CASTRO, Lucia
dc.contributor.authorMUNGUAMBE, Shilzia
dc.contributor.authorSAAVEDRA-CERVERA, Belen
dc.contributor.authorDE HAAS, Petra
dc.contributor.authorKAY, Alexander
hal.structure.identifierBordeaux population health [BPH]
hal.structure.identifierGlobal Health in the Global South [GHiGS]
dc.contributor.authorMARCY, Olivier
dc.contributor.authorNABETA, Pamela
dc.contributor.authorSSENGOOBA, Willy
dc.contributor.authorGHIMENTON-WALTERS, Elisabetta
dc.contributor.authorACACIO, Sozinho
dc.contributor.authorBONNET, Maryline
dc.contributor.authorEHRLICH, Joanna
dc.contributor.authorDINARDO, Andrew R
dc.contributor.authorVASILIU, Anca
dc.contributor.authorLANGE, Christoph
dc.contributor.authorHERMANS, Sabine
dc.contributor.authorMANDALAKAS, Anna M
dc.contributor.authorLOPEZ-VARELA, Elisa
dc.contributor.authorGARCIA-BASTEIRO, Alberto L
dc.contributor.authorSTOOL, T. B. Global Partnership
dc.date.accessioned2024-12-13T09:06:43Z
dc.date.available2024-12-13T09:06:43Z
dc.date.issued2024-11-09
dc.identifier.issn2666-5247en_US
dc.identifier.urihttps://oskar-bordeaux.fr/handle/20.500.12278/203913
dc.description.abstractEnBACKGROUND: There has been a global pursuit to improve the diagnosis of tuberculosis in young children by applying diagnostic methods on accessible biospecimens such as stool. We aimed to conduct a systematic review on the accuracy of stool-based molecular tests for tuberculosis diagnosis in children and to assess the impact of the available pre-processing methods and other design characteristics. METHODS: In this systematic review and meta-analysis, we evaluated studies in children younger than 16 years with presumptive tuberculosis that were published in English, Spanish, French, and Portuguese from Jan 1, 2000, to May 3, 2024, in MEDLINE, Embase, and Embase Classic, comparing the molecular detection of Mycobacterium tuberculosis DNA in stool with microbiological tests on other samples or a clinical diagnosis. We did not exclude studies based on geographical location, sample size, or study design if they were reporting primary data. Two independent reviewers (LC-C and SM) screened titles, abstracts, and full-text articles for eligibility and extracted data on study characteristics, study population, and diagnostic performance. If information relevant to the main analysis was not reported in the article, the corresponding authors were contacted. Point estimates and 95% CIs were calculated for sensitivity and specificity for each study and for the different molecular tests (Xpert MTB/RIF, Xpert Ultra MTB/RIF [Cepheid, Sunnyvale, CA, USA], and other tests) versus a reference standard (culture only, any bacteriological confirmation, and tuberculosis case definition). Sensitivity and specificity were stratified by the stool processing method. We also quantified the additionality of stool Xpert Ultra tests for tuberculosis bacteriological confirmation. The protocol was registered with PROSPERO, CRD42022341514. FINDINGS: A total of 4521 records were identified through the database search, one record was identified from an article bibliography, and 67 studies were retained for full-text reading. 39 studies were included in the qualitative synthesis, 35 of which were included in the meta-analyses. When using any bacteriological confirmation from a respiratory sample as the reference standard, stool Xpert sensitivity was 0·60 (95% CI 0·48-0·71), stool Xpert Ultra sensitivity was 0·73 (0·63-0·81), and sensitivity was 0·44 (0·29-0·60) for other in-house molecular methods combined. When using tuberculosis case definition as the reference standard, stool Xpert sensitivity was 0·23 (0·11-0·41), stool Xpert Ultra sensitivity was 0·38 (0·22-0·56), and sensitivity was 0·17 (0·09-0·23) for other in-house molecular methods. The addition of stool Xpert Ultra increased bacteriological confirmation of tuberculosis by 38·6% overall. Further, the utilisation of centrifuge-free simplified methods improved the sensitivity of stool Xpert Ultra when using any bacteriological confirmation as a reference standard (0·77 [0·66-0·85] for centrifuge-free methods vs 0·61 [0·41-0·78] for non-centrifuge-free methods). INTERPRETATION: This systematic review and meta-analysis supports the use of Xpert Ultra in stool samples as a diagnostic tool for paediatric tuberculosis diagnosis. Stool-based Xpert Ultra can contribute to increase the bacteriological confirmation in this population, even when respiratory specimens are also tested. FUNDING: The EDCTP2 programme supported by the EU via Stool4TB Project and the European Society of Pediatric Infectious Diseases.
dc.language.isoENen_US
dc.rightsAttribution-NonCommercial-NoDerivs 3.0 United States*
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/3.0/us/*
dc.title.enPerformance of stool-based molecular tests and processing methods for paediatric tuberculosis diagnosis: a systematic review and meta-analysis
dc.title.alternativeLancet Microbeen_US
dc.typeArticle de revueen_US
dc.identifier.doi10.1016/j.lanmic.2024.100963en_US
dc.subject.halSciences du Vivant [q-bio]/Santé publique et épidémiologieen_US
dc.identifier.pubmed39547244en_US
bordeaux.journalThe Lancet Microbeen_US
bordeaux.page100963en_US
bordeaux.hal.laboratoriesBordeaux Population Health Research Center (BPH) - UMR 1219en_US
bordeaux.institutionUniversité de Bordeauxen_US
bordeaux.institutionINSERMen_US
bordeaux.teamGHIGS_BPHen_US
bordeaux.peerReviewedouien_US
bordeaux.inpressnonen_US
bordeaux.identifier.funderIDInstitut de Recherche pour le Développementen_US
bordeaux.identifier.funderIDEuropean Society for Paediatric Infectious Diseasesen_US
hal.identifierhal-04835456
hal.version1
hal.date.transferred2024-12-13T09:06:47Z
hal.popularnonen_US
hal.audienceInternationaleen_US
hal.exporttrue
dc.rights.ccPas de Licence CCen_US
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