title: Stool Xpert®MTB/RIF test for the diagnosis of childhood pulmonary tuberculosis at primary clinics in Zimbabwe.
abstract: To evaluate the diagnostic performance of Xpert® MTB/RIF on stool samples from children with clinical suspicion of pulmonary tuberculosis (PTB) at primary care clinics.
  
  
  
  A cross-sectional diagnostic evaluation enrolling 5-16 year olds from whom one induced sputum (IS) sample was tested for microbiological TB confirmation. Results of a single stool sample tested using Xpert were compared against microbiologically confirmed TB, defined as a positive result on sputum microscopy and/or culture and/or IS Xpert.
  
  
  
  Of 222 children enrolled, 218 had complete microbiological results. The median age was 10.6 years (interquartile range 8-13). TB was microbiologically confirmed in 19/218 (8.7%) children. Of these, respectively 5 (26%), 9 (47%) and 15 (79%) were smear-, culture- and IS Xpert-positive. Stool Xpert was positive in 13/19 (68%) microbiologically confirmed cases and 4/199 (2%) microbiologically negative cases. Stool Xpert detected 76.9% (10/13) of human immunodeficiency virus (HIV) infected and 50% (3/6) of non-HIV-infected children with microbiologically confirmed TB (P = 0.241).
  
  
  
  Stool Xpert is a potential alternative screening test for children with suspected TB if sputum is unavailable. Strategies to optimise the diagnostic yield of stool Xpert assay need further study.
authors.affiliation: University of Zimbabwe College of Health Sciences, Medical Laboratory Sciences, Harare.
authors.forename: M
authors.initials: M
authors.lastname: Chipinduro
authors.affiliation: University of Zimbabwe College of Health Sciences, Research Support Centre, Harare, Zimbabwe.
authors.forename: K
authors.initials: K
authors.lastname: Mateveke
authors.affiliation: Biomedical Research and Training Institute, Harare, Zimbabwe.
authors.forename: B
authors.initials: B
authors.lastname: Makamure
authors.affiliation: Biomedical Research and Training Institute, Harare, Zimbabwe, Zimbabwe; Clinical Research Department, London School of Hygiene & Tropical Medicine, London, UK.
authors.forename: R A
authors.initials: RA
authors.lastname: Ferrand
authors.affiliation: University of Zimbabwe College of Health Sciences, Medical Laboratory Sciences, Harare, Zimbabwe; Traditional Medical Laboratory, University of KwaZulu-Natal, Durban, South Africa.
authors.forename: E
authors.initials: E
authors.lastname: Gomo
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005243:Feces / Q000382:microbiology*; D005260:Female; D006801:Humans; D008297:Male; D008853:Microscopy / Q000379:methods; D021141:Nucleic Acid Amplification Techniques / Q000379:methods*; D016133:Polymerase Chain Reaction / Q000379:methods*; D011320:Primary Health Care / Q000379:methods; D013183:Sputum / Q000382:microbiology; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis* / Q000453:epidemiology / Q000382:microbiology; D015030:Zimbabwe