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Introduction of the Simple One-Step stool Xpert Ultra method to detect TB in children and adults

P de Haas1, N V Nhung2, N T Hng3

  • 1KNCV Tuberculosis Foundation, The Hague, The Netherlands.

The International Journal of Tuberculosis and Lung Disease : the Official Journal of the International Union Against Tuberculosis and Lung Disease
|February 28, 2023
PubMed

Insights

Tuberculosis (TB) diagnosis in children and people living with HIV (PLHIV) improved using a simple stool test. This non-invasive method is feasible and acceptable for healthcare workers, increasing TB detection rates.

Area of Science:

  • Infectious Diseases
  • Microbiology
  • Public Health

Background:

  • Tuberculosis (TB) diagnosis in vulnerable populations like children and people living with HIV (PLHIV) remains challenging.
  • Sputum-based diagnostics are often difficult for these groups, necessitating alternative sample types.

Purpose of the Study:

  • To assess the feasibility, acceptability, and impact of a Simple One-Step (SOS) stool processing method using Xpert® MTB/RIF Ultra for TB diagnosis.
  • To evaluate healthcare worker (HCW) perceptions of stool sample collection and processing.

Main Methods:

  • A pilot implementation of the SOS stool method was conducted by Vietnam's National TB Programme (NTP) in 2020.
  • Data on HCW perceptions and test results were collected and analyzed.

Main Results:

  • HCWs found stool collection least stressful and the SOS method easy to perform.
  • The SOS stool test demonstrated a low rate (<5%) of non-determinate results after an induction period.
  • Combined respiratory and stool sample testing increased bacteriologically confirmed TB by 4.1% in PLHIV and 3.9% in children.
  • Mycobacterium tuberculosis was detected more frequently in stool (26.1%) than respiratory samples (23.4%) among children.

Conclusions:

  • Stool testing is a feasible and acceptable non-invasive diagnostic tool for TB in adult PLHIV and children.
  • Routine stool testing offers a valuable alternative for patients unable to produce sputum, improving TB diagnosis rates.

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