Non-sputum-based triage and confirmatory diagnostic tests for pediatric TB

Document Type

Journal Article

Publication Date

3-1-2025

Journal

IJTLD open

Volume

2

Issue

3

DOI

10.5588/ijtldopen.24.0484

Keywords

diagnostics; non-sputum diagnostics; pediatric TB; triage; tuberculosis

Abstract

BACKGROUND: Non-sputum-based triage and confirmatory tests are essential for early TB detection and timely treatment in children. METHODS: A mini-review was conducted from January 2022 to May 2024, evaluating five studies on non-sputum-based assays for childhood TB diagnosis. Both Microbiological and Clinical Reference Standards were used to assess diagnostic accuracy and triage potential. RESULTS: Among the confirmatory tests, only the gastric aspiration test with cartridge-based nucleic acid amplification tests (CBNAAT) met the WHO Target Product Profile criteria. However, this method remains invasive and is not suitable for point-of-care testing. Urine testing by gas chromatography-mass spectrometry (GC/MS) or C-ELISA (BJ76/A194) demonstrated high performance but lacked point-of-care applicability in resource-limited settings. Stool testing with CBNAAT is a viable alternative with high specificity but low sensitivity. For triage, urine lipoarabinomannan tests and blood MTB-HR tests show promise based on specificity, practicality, cost, and turnaround time. CONCLUSION: This review highlights the performance of non-sputum-based assays for childhood TB and their potential as triage tools. While some other innovations show promise for the triage and/or diagnosis of TB in adults, further studies are needed to evaluate the performance of these tests in pediatric populations.

Department

School of Medicine and Health Sciences Student Works

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