Non-sputum-based triage and confirmatory diagnostic tests for pediatric TB

BACKGROUND: Non-sputum-based triage and confirmatory tests are essential for early TB detection and timely treatment in children. METHODS: A mini-review was conducted from January 2022 to May 2024, evaluating five studies on non-sputum-based assays for childhood TB diagnosis. Both Microbiological an...

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Main Authors: A. Drane, A. Molkenthin, M. Gassama, S. Pouzol, P. Vanhems, J. Hoffmann
Format: Article
Language:English
Published: International Union Against Tuberculosis and Lung Disease (The Union) 2025-03-01
Series:IJTLD Open
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Online Access:https://www.ingentaconnect.com/contentone/iuatld/ijtldo/2025/00000002/00000003/art00006
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author A. Drane
A. Molkenthin
M. Gassama
S. Pouzol
P. Vanhems
J. Hoffmann
author_facet A. Drane
A. Molkenthin
M. Gassama
S. Pouzol
P. Vanhems
J. Hoffmann
author_sort A. Drane
collection DOAJ
description BACKGROUND: Non-sputum-based triage and confirmatory tests are essential for early TB detection and timely treatment in children. METHODS: A mini-review was conducted from January 2022 to May 2024, evaluating five studies on non-sputum-based assays for childhood TB diagnosis. Both Microbiological and Clinical Reference Standards were used to assess diagnostic accuracy and triage potential. RESULTS: Among the confirmatory tests, only the gastric aspiration test with cartridge-based nucleic acid amplification tests (CBNAAT) met the WHO Target Product Profile criteria. However, this method remains invasive and is not suitable for point-of-care testing. Urine testing by gas chromatography–mass spectrometry (GC/MS) or C-ELISA (BJ76/A194) demonstrated high performance but lacked point-of-care applicability in resource-limited settings. Stool testing with CBNAAT is a viable alternative with high specificity but low sensitivity. For triage, urine lipoarabinomannan tests and blood MTB-HR tests show promise based on specificity, practicality, cost, and turnaround time. CONCLUSION: This review highlights the performance of non-sputum-based assays for childhood TB and their potential as triage tools. While some other innovations show promise for the triage and/or diagnosis of TB in adults, further studies are needed to evaluate the performance of these tests in pediatric populations.
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spelling doaj-art-3ef24e59f83548ec90b1d8af811a577c2025-08-20T02:57:03ZengInternational Union Against Tuberculosis and Lung Disease (The Union)IJTLD Open3005-75902025-03-012315315910.5588/ijtldopen.24.04846Non-sputum-based triage and confirmatory diagnostic tests for pediatric TBA. Drane0A. Molkenthin1M. Gassama2S. Pouzol3P. Vanhems4J. Hoffmann5George Washington University, Milken Institute School of Public Health, Washington, DC, USA;Mérieux Foundation USA, Washington, DC, USA;George Washington University, Milken Institute School of Public Health, Washington, DC, USA;Fondation Mérieux, Lyon, France;Fondation Mérieux, Lyon, France;Fondation Mérieux, Lyon, France;BACKGROUND: Non-sputum-based triage and confirmatory tests are essential for early TB detection and timely treatment in children. METHODS: A mini-review was conducted from January 2022 to May 2024, evaluating five studies on non-sputum-based assays for childhood TB diagnosis. Both Microbiological and Clinical Reference Standards were used to assess diagnostic accuracy and triage potential. RESULTS: Among the confirmatory tests, only the gastric aspiration test with cartridge-based nucleic acid amplification tests (CBNAAT) met the WHO Target Product Profile criteria. However, this method remains invasive and is not suitable for point-of-care testing. Urine testing by gas chromatography–mass spectrometry (GC/MS) or C-ELISA (BJ76/A194) demonstrated high performance but lacked point-of-care applicability in resource-limited settings. Stool testing with CBNAAT is a viable alternative with high specificity but low sensitivity. For triage, urine lipoarabinomannan tests and blood MTB-HR tests show promise based on specificity, practicality, cost, and turnaround time. CONCLUSION: This review highlights the performance of non-sputum-based assays for childhood TB and their potential as triage tools. While some other innovations show promise for the triage and/or diagnosis of TB in adults, further studies are needed to evaluate the performance of these tests in pediatric populations.https://www.ingentaconnect.com/contentone/iuatld/ijtldo/2025/00000002/00000003/art00006tuberculosispediatric tbnon-sputum diagnosticstriagediagnostics
spellingShingle A. Drane
A. Molkenthin
M. Gassama
S. Pouzol
P. Vanhems
J. Hoffmann
Non-sputum-based triage and confirmatory diagnostic tests for pediatric TB
IJTLD Open
tuberculosis
pediatric tb
non-sputum diagnostics
triage
diagnostics
title Non-sputum-based triage and confirmatory diagnostic tests for pediatric TB
title_full Non-sputum-based triage and confirmatory diagnostic tests for pediatric TB
title_fullStr Non-sputum-based triage and confirmatory diagnostic tests for pediatric TB
title_full_unstemmed Non-sputum-based triage and confirmatory diagnostic tests for pediatric TB
title_short Non-sputum-based triage and confirmatory diagnostic tests for pediatric TB
title_sort non sputum based triage and confirmatory diagnostic tests for pediatric tb
topic tuberculosis
pediatric tb
non-sputum diagnostics
triage
diagnostics
url https://www.ingentaconnect.com/contentone/iuatld/ijtldo/2025/00000002/00000003/art00006
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AT mgassama nonsputumbasedtriageandconfirmatorydiagnostictestsforpediatrictb
AT spouzol nonsputumbasedtriageandconfirmatorydiagnostictestsforpediatrictb
AT pvanhems nonsputumbasedtriageandconfirmatorydiagnostictestsforpediatrictb
AT jhoffmann nonsputumbasedtriageandconfirmatorydiagnostictestsforpediatrictb