Routine investigations used in the diagnosis of childhood tuberculosis

Abstract

World Health Organization approved the use of Xpert MTB/RIF Ultra (Ultra) in children due to quick turn-around time, improved yield over smear microscopy, and ability to detect rifampicin resistance despite culture being the gold standard. This study reviewed published literature on childhood tuberculosis diagnostic modalities.

For childhood tuberculosis (TB) diagnostic modalities, PubMed was searched using Boolean terms OR/AND between childhood tuberculosis and words such as diagnosis, polymerase chain reaction, molecular, histology, imaging, and cultures. All abstracts were read, after which selected articles that met this article's objectives were thoroughly reviewed and referenced appropriately.

Ultra is an important diagnostic method for confirming TB in children even though mycobacterial culture, other molecular, and histology tests are used in the diagnosis of pulmonary and extrapulmonary TB. Modalities such as imaging and immunologic testing support the diagnosis of microbiologically unconfirmed TB.

Despite advances in the diagnostic tools for tuberculosis in children, the sensitivity and specificity of such tests are still relatively low. Clinical criteria of TB still play a role in deciding whether to treat children for TB.