Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

Comparison of Xpert MTB/RIF Ultra Results of Stool and Sputum in Children with Presumptive Tuberculosis in Southern Ethiopia

Yohannes Babo
* ORCID logo ,
Bihil Seremolo
,
Mamush Bogale
,
Yasin Wabe
,
Haba Churako
ORCID logo ,
Alemu Bilat
,
Tamiru Degaga
,
Ahmed Oumer
,
Petra Haas
,
Edine Tiemersma
,
Degu Jerene
Version 1 : Received: 25 May 2023 / Approved: 26 May 2023 / Online: 26 May 2023 (13:38:35 CEST)

A peer-reviewed article of this Preprint also exists.

Babo, Y.; Seremolo, B.; Bogale, M.; Bedru, A.; Wabe, Y.; Churako, H.; Bilat, A.; Degaga, T.; Haas, P.D.; Tiemersma, E.; Jerene, D. Comparison of Xpert MTB/RIF Ultra Results of Stool and Sputum in Children with Presumptive Tuberculosis in Southern Ethiopia. Trop. Med. Infect. Dis. 2023, 8, 350. Babo, Y.; Seremolo, B.; Bogale, M.; Bedru, A.; Wabe, Y.; Churako, H.; Bilat, A.; Degaga, T.; Haas, P.D.; Tiemersma, E.; Jerene, D. Comparison of Xpert MTB/RIF Ultra Results of Stool and Sputum in Children with Presumptive Tuberculosis in Southern Ethiopia. Trop. Med. Infect. Dis. 2023, 8, 350.

Abstract

The introduction of stool as a readily obtainable sample and the recently developed simple-one-step (SOS) stool processing method offer an opportunity for TB diagnosis in children. We conducted this study at secondary health facilities in Ethiopia which are the first level referral facilities for childhood TB diagnosis and treatment with the aim to determine if stool-based TB diagnosis can be performed with reasonable level of concordance with sputum tests in using Xpert MTB/RIF Ultra. Eligible children 0-14 years with presumptive pulmonary TB were asked to provide stools in addition to routinely requested sputum samples. We computed Cohen’s kappa statistic in SPSS to determine the level of agreement between stool and sputum test results. Of the 373 children included in the study, 61% were <5 years of age and 56% were male. Thirty-six children (9.7%) were diagnosed with TB and all started treatment. The rate of concordance between stool and sputum was high with kappa value of 0.83 (P<0.001). There were more Xpert ultra positive test results on stool (n=27 (7.2%)) than on sputum/NGA (n=23 (6.2%)). Laboratories in secondary hospitals can perform stool-based TB diagnosis in children with high concordance between stool and sputum test results reaffirming the applicability of the SOS method.

Keywords

Simple One-Step (SOS) stool processing method stool; Xpert MTB/RIF (Ultra) assay and children

Subject

Public Health and Healthcare, Public Health and Health Services

Copyright: This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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