Poo testing the new breakthrough in child TB

Poo testing the new breakthrough in child TBOn average, MDR-TB wait 16 days to start treatment after being tested with the GeneXpert.

A much simpler test to detect tuberculosis (TB) in children, using a stool sample instead of sputum, could save thousands of lives.

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The brainchild of Petra De Haas from the KNCV Tuberculosis Foundation, the results of the innovative test were presented on Wednesday at the 49thUnion World Conference on Lung Health in The Netherlands.

Ninety-six percent of the children who die from TB each year had no access to diagnosis which means, in theory, this easier test could save 200 000 lives if becomes available to everyone.

Currently about 239 000 children die of TB every year around the world. With access to treatment children rarely die, but more than 90 percent of the deaths occurred in kids who did not receive anti-TB drugs.

According to De Haas, this is mainly because it is so difficult to diagnose TB in children because they cannot spit up sputum. Health workers have to resort to alternative methods which are “complex, invasive, stressful and painful” and often require the child to be hospitalised overnight.

Gold standard accuracy

The researchers tested 36 children in Indonesia, taking both a sputum sample and a stool sample and found that using kids’ poo to detect TB was as accurate as the golden-standard using sputum.

“Ninety-six percent of the children who die from TB each year had no access to diagnosis which means, in theory, this easier test could save 200 000 lives if becomes available to everyone,” said KNCV’s Edine Tiemersma.

The researchers used the same equipment traditionally used to test sputum samples, the GeneXpert machine, which means that changing the sample to stool would not require any additional resources.

The results need to be confirmed in bigger studies before the World Health Organisation can recommend the method in their official guidelines for countries.

The researchers will start enrolling about 750 children from Indonesia and Ethiopia into a bigger study before the end of this year.

Executive Director of the International Union Against Tuberculosis and Lung Disease Jose Luis Castro said that there “is an urgent need to drastically step up investment in research and development that can deliver new and better diagnostic tools such as this stool test”.

Said Castro: “No child should die of TB.”