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Diagnostic Advances in Childhood Tuberculosis-Improving Specimen Collection and Yield of Microbiological Diagnosis for Intrathoracic Tuberculosis. 2022

Eric Wobudeya, and Maryline Bonnet, and Elisabetta Ghimenton Walters, and Pamela Nabeta, and Rinn Song, and Wilfred Murithi, and Walter Mchembere, and Bunnet Dim, and Jean-Voisin Taguebue, and Joanna Orne-Gliemann, and Mark P Nicol, and Olivier Marcy
Makerere University-Johns Hopkins University Research Collaboration (MU-JHU) Care Ltd., Kampala P.O. Box 7072, Uganda.

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.

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