Wobudeya Eric, Bonnet Maryline, Walters Elisabetta Ghimenton, Nabeta Pamela, Song Rinn, Murithi Wilfred, Mchembere Walter, Dim Bunnet, Taguebue Jean-Voisin, Orne-Gliemann Joanna, Nicol Mark P, Marcy Olivier
Makerere University-Johns Hopkins University Research Collaboration (MU-JHU) Care Ltd., Kampala P.O. Box 7072, Uganda.
University of Montpellier, IRD, INSERM, TransVIH MI, 34090 Montpellier, France.
Pathogens. 2022 Mar 23;11(4):389. doi: 10.3390/pathogens11040389.
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.
儿童结核病（TB）诊断尚无微生物学金标准。该疾病的少菌特性、幼儿样本采集的挑战以及现有微生物学检测的局限性，使得仅少数儿童的胸内结核能通过微生物学得到确诊。世界卫生组织（WHO）近期指南推荐使用新型快速分子检测作为结核病的初始诊断检测，并认可针对儿童的替代样本采集方法。然而，在高流行地区，这些工具的采用率仍然很低。在本综述中，我们评估了可用于诊断儿童胸内结核的历史和新型微生物学检测方法及样本采集技术。我们探讨了尽管存在局限性但提高诊断率的挑战和可能方法，并确定了为改善儿童胸内结核微生物学诊断需解决的研究空白。
