Diagnostic Advances in Childhood Tuberculosis-Improving Specimen Collection and Yield of Microbiological Diagnosis for Intrathoracic Tuberculosis

Eric Wobudeya; Maryline Bonnet; Elisabetta Ghimenton Walters; Pamela Nabeta; Rinn Song; Wilfred Murithi; Walter Mchembere; Bunnet Dim; Jean-Voisin Taguebue; Joanna Orne-Gliemann; Mark P Nicol; Olivier Marcy

doi:10.3390/pathogens11040389

Diagnostic Advances in Childhood Tuberculosis-Improving Specimen Collection and Yield of Microbiological Diagnosis for Intrathoracic Tuberculosis

Pathogens. 2022 Mar 23;11(4):389. doi: 10.3390/pathogens11040389.

Authors

Eric Wobudeya¹, Maryline Bonnet², Elisabetta Ghimenton Walters^{3

4}, Pamela Nabeta⁵, Rinn Song⁶, Wilfred Murithi⁷, Walter Mchembere⁸, Bunnet Dim⁹, Jean-Voisin Taguebue¹⁰, Joanna Orne-Gliemann¹¹, Mark P Nicol^{12

13}, Olivier Marcy¹¹

Affiliations

¹ Makerere University-Johns Hopkins University Research Collaboration (MU-JHU) Care Ltd., Kampala P.O. Box 7072, Uganda.
² University of Montpellier, IRD, INSERM, TransVIH MI, 34090 Montpellier, France.
³ Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Stellenbosch University, Cape Town 8000, South Africa.
⁴ Great North Children's Hospital, Newcastle-upon-Tyne Hospitals Trust, Newcastle Upon Tyne NE1 4LP, UK.
⁵ FIND, Chemin des Mines 9, 1202 Geneva, Switzerland.
⁶ Oxford Vaccine Group, Department of Paediatrics, University of Oxford, Oxford OX 7LEe, UK.
⁷ Center for Respiratory Disease Research, Kenya Medical Research Institute, Nairobi 00100, Kenya.
⁸ Center for Global Health Research, Kenya Medical Research Institute, Kisumu 40100, Kenya.
⁹ Epidemiology and Public Health Unit, Pasteur Institute in Cambodia, Phnom Penh 12201, Cambodia.
¹⁰ Mother and Child Center, Chantal Biya Foundation, Yaoundé P.O. Box 1936, Cameroon.
¹¹ University of Bordeaux, National Institute for Health and Medical Research (INSERM), Research Institute for Sustainable Development (IRD), Bordeaux Population Health Research Centre, Team GHiGS, 33000 Bordeaux, France.
¹² Division of Infection and Immunity, School of Biomedical Sciences, University of Western Australia, Perth, WA 6009, Australia.
¹³ Division of Medical Microbiology and Institute for Infectious Diseases and Molecular Medicine, University of Cape Town, Cape Town 7701, South Africa.

Abstract

There is no microbiological gold standard for childhood tuberculosis (TB) diagnosis. The paucibacillary nature of the disease, challenges in sample collection in young children, and the limitations of currently available microbiological tests restrict microbiological confirmation of intrathoracic TB to the minority of children. Recent WHO guidelines recommend the use of novel rapid molecular assays as initial diagnostic tests for TB and endorse alternative sample collection methods for children. However, the uptake of these tools in high-endemic settings remains low. In this review, we appraise historic and new microbiological tests and sample collection techniques that can be used for the diagnosis of intrathoracic TB in children. We explore challenges and possible ways to improve diagnostic yield despite limitations, and identify research gaps to address in order to improve the microbiological diagnosis of intrathoracic TB in children.

Keywords: children; diagnosis; microbiological tests; sample collection methods; tuberculosis.

Publication types

Review