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Updated: May 24, 2025
08:10
Diagnosing Pulmonary Tuberculosis with the Xpert MTB/RIF Test
Published on: April 9, 2012
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Lessons Learned from Early Implementation and Scale-up of Stool-Based Xpert Testing to Diagnose Tuberculosis in
Emerging Infectious Diseases
|March 2, 2025
Summary
Fecal testing for Mycobacterium tuberculosis complex (MTBC) in children using the Xpert MTB/RIF assay is proving effective. This noninvasive method enhances TB case finding, showing a 4.1% detection yield in early-adopter countries.
Area of Science:
- Pediatric infectious diseases
- Microbiology
- Global health
Background:
- Fecal testing for Mycobacterium tuberculosis complex (MTBC) using the Cepheid Xpert MTB/RIF assay was recommended in 2020 for diagnosing childhood TB.
- Early-adopter countries have implemented stool-based testing as part of strategies to improve TB case finding in children.
Purpose of the Study:
- To determine insights from nine early-adopter countries regarding the implementation of fecal testing for MTBC in children.
- To assess the yield and feasibility of stool-based Xpert MTB/RIF testing in pediatric TB diagnosis.
Main Methods:
- Analysis of data from 9 countries that implemented stool testing for MTBC in children between October 2020 and September 2023.
- Review of experience-sharing workshop findings from November 2023.
Main Results:
- Over 121 months, 71,757 children underwent stool testing, with 2,892 (4.1% overall yield) testing positive for MTBC.
- Rifampin resistance was detected in 43 stool samples.
- Stool collection was reported as noninvasive and comparable in ease to sputum testing.
Conclusions:
- Stool-based Xpert MTB/RIF testing is a viable and effective tool for diagnosing MTBC infection in children.
- This noninvasive diagnostic approach can be integrated into peripheral healthcare settings to increase bacteriologic confirmation of presumptive childhood TB.
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