Diagnostic accuracy of Xpert MTB/RIF Ultra for childhood tuberculosis in West Africa – a multicenter pragmatic study

Awa Ba Diallo, Victory F. Edem, Arnauld Fiogbe, Kwabena A. Osman, Mohamed Tolofoudie, Amadou Somboro, Bassirou Diarra, Babatunde Ogunbosi, Ibrahim Abok, Augustine O. Ebonyi, Bamenla Goka, Dissou Affolabi, Regina Oladokun, Aderemi O. Kehinde, Nuredin Mohammed, Toyin Togun

Research output: Contribution to journalArticlepeer-review

1 Citation (Scopus)

Abstract

Objective: To evaluate the performance of Xpert Mycobacterium Tuberculosis/rifampicin (MTB/RIF) Ultra (Ultra) for diagnosis of childhood tuberculosis (TB) within public health systems. Methods: In this cross-sectional study, children aged <15 years with presumptive pulmonary TB were consecutively recruited and evaluated for TB at tertiary-level hospitals in Benin, Mali, and Ghana. Bivariate random-effects models were used to determine the pooled sensitivity and specificity of Ultra against culture. We also estimated its diagnostic yield against a composite microbiological reference standard (cMRS) of positive culture or Ultra. Results: Overall, 193 children were included in the analyses with a median (interquartile range) age of 4.0 (1.1-9.2) years, 88 (45.6%) were female, and 36 (18.7%) were HIV-positive. Thirty-one (16.1%) children had confirmed TB, 39 (20.2%) had unconfirmed TB, and 123 (63.7%) had unlikely TB. The pooled sensitivity and specificity of Ultra verified by culture were 55.0% (95% confidence interval [CI]: 28.0–79.0%) and 95.0% (95% CI: 88.0–98.0%), respectively. Against the cMRS, the diagnostic yield of Ultra and culture were 67.7% (95% CI: 48.6–83.3%) and 70.9% (95% CI: 51.9–85.8%), respectively. Conclusion: Ultra has suboptimal sensitivity in children with TB that were investigated under routine conditions in tertiary-level hospitals in three West African countries.

Original languageEnglish
Pages (from-to)86-91
Number of pages6
JournalInternational Journal of Infectious Diseases
Volume140
DOIs
Publication statusPublished - Mar 2024

Keywords

  • Children
  • Diagnostic accuracy
  • GeneXpert
  • Tuberculosis

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