Diagnosis of Tuberculosis Using Gastric Aspirates in Pediatric Patients in Haiti

Area of Science:

• Pediatric Infectious Diseases
• Microbiology
• Molecular Diagnostics

Background:

• Tuberculosis (TB) diagnosis in children under 5 years often relies on non-specific clinical signs.
• Gastric lavage aspirates (GLAs) are a common sample type for pediatric TB diagnosis.
• Improving microbiologic confirmation is crucial for timely and effective TB treatment.

Purpose of the Study:

• To evaluate the Xpert MTB/RIF assay as an adjunct to culture for diagnosing TB in young children using GLAs.
• To compare the diagnostic yield of Xpert, culture, and smear microscopy in this population.

Main Methods:

• Retrospective review of diagnostic modalities in children suspected of TB.
• Analysis of data from an infectious disease research center in Haiti (2011-2016).
• Comparison of microbiologic yield from culture, Xpert MTB/RIF, and smear microscopy on GLAs.

Main Results:

• Microbiologic diagnosis was achieved in 21% of 187 children clinically diagnosed with TB.
• Xpert MTB/RIF detected 17% of cases, culture 19%, and smear microscopy 1.6%.
• Xpert identified 10 additional cases not detected by culture alone, increasing yield by 33%.

Conclusions:

• Xpert MTB/RIF significantly enhances the microbiologic diagnosis of TB in children via GLAs.
• The rapid results from Xpert facilitate prompt initiation of TB treatment.
• Smear microscopy shows low sensitivity in GLAs and offers limited diagnostic value.