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
Affiliations
Eric Wobudeya
Makerere University-Johns Hopkins University Research Collaboration (MU-JHU) Care Ltd., Kampala P.O. Box 7072, Uganda
Maryline Bonnet
University of Montpellier, IRD, INSERM, TransVIH MI, 34090 Montpellier, France
Elisabetta Ghimenton Walters
Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Stellenbosch University, Cape Town 8000, South Africa
Pamela Nabeta
FIND, Chemin des Mines 9, 1202 Geneva, Switzerland
Rinn Song
Oxford Vaccine Group, Department of Paediatrics, University of Oxford, Oxford OX 7LEe, UK
Wilfred Murithi
Center for Respiratory Disease Research, Kenya Medical Research Institute, Nairobi 00100, Kenya
Walter Mchembere
Center for Global Health Research, Kenya Medical Research Institute, Kisumu 40100, Kenya
Bunnet Dim
Epidemiology and Public Health Unit, Pasteur Institute in Cambodia, Phnom Penh 12201, Cambodia
Jean-Voisin Taguebue
Mother and Child Center, Chantal Biya Foundation, Yaoundé P.O. Box 1936, Cameroon
Joanna Orne-Gliemann
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
Mark P. Nicol
Division of Infection and Immunity, School of Biomedical Sciences, University of Western Australia, Perth, WA 6009, Australia
Olivier Marcy
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
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.
