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Updated: May 24, 2025

Diagnosing Pulmonary Tuberculosis with the Xpert MTB/RIF Test
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

Eveline Klinkenberg, Petra de Haas, Charles Manyonge

    Emerging Infectious Diseases
    |March 2, 2025
    PubMed

    Insights

    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.

    Keywords:
    AfricaAsiaCentral AsiaNTPXpert MTB/RIF Ultrabacteriachildrenfecal testingstooltuberculosistuberculosis and other mycobacteria

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