{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T22:23:11Z","timestamp":1787869391424,"version":"build-2784847793"},"reference-count":28,"publisher":"Oxford University Press (OUP)","issue":"12","license":[{"start":{"date-parts":[[2022,5,17]],"date-time":"2022-05-17T00:00:00Z","timestamp":1652745600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"name":"Regional Prospective Observational Research in Tuberculosis"},{"DOI":"10.13039\/501100001322","name":"Medical Research Council of South Africa","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100001322","id-type":"DOI","asserted-by":"crossref"}]},{"name":"US Office of AIDS Research,"},{"DOI":"10.13039\/501100001322","name":"Medical Research Council of South Africa","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100001322","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Tuberculosis Collaborating Centre for Child Health"},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"crossref","award":["RO1HD058971"],"award-info":[{"award-number":["RO1HD058971"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100013996","name":"Global Health Innovative Technology","doi-asserted-by":"crossref","award":["G2017-207"],"award-info":[{"award-number":["G2017-207"]}],"id":[{"id":"10.13039\/501100013996","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Australian National Health"},{"name":"Medical Research Council","award":["APP1174455"],"award-info":[{"award-number":["APP1174455"]}]},{"name":"SA-MRC"},{"DOI":"10.13039\/100000060","name":"National Institute of Allergy and Infectious Diseases","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100000060","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,12,19]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Microbiologic diagnosis of childhood tuberculosis may be difficult. Oral swab specimens are a potential noninvasive alternative to sputum specimens for diagnosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This was a prospective diagnostic accuracy study of oral swab specimens (buccal and tongue) for pulmonary tuberculosis diagnosis in children (aged \u2264 15 years) in 2 South African hospital sites. Children with cough of any duration as well as a positive tuberculin skin test result, tuberculosis contact, loss of weight, or chest radiograph suggestive of pulmonary tuberculosis were enrolled. Two induced sputum specimens were tested with Xpert MTB\/RIF (or Xpert MTB\/RIF Ultra) assay and liquid culture. Oral swab specimens were obtained before sputum specimens, frozen, and later tested with Xpert MTB\/RIF Ultra. Children were classified as microbiologically confirmed tuberculosis, unconfirmed tuberculosis (receipt of tuberculosis treatment), or unlikely tuberculosis according to National Institutes of Health consensus definitions based on sputum microbiologic results.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 291 participants (median age [interquartile range], 32 [14\u201373] months), 57 (20%) had human immunodeficiency virus (HIV), and 87 (30%) were malnourished; 90 (31%) had confirmed pulmonary tuberculosis (rifampicin resistant in 6 [7%] ), 157 (54%), unconfirmed pulmonary tuberculosis, and 44 (15%), unlikely tuberculosis. A single oral swab specimen was obtained from 126 (43%) of the participants (tongue in 96 and buccal in 30) and 2 swab specimens from 165 (57%) (tongue in 110 and buccal in 55). Sensitivity was low (22% [95% confidence interval, 15%\u201332%]) for all swab specimens combined (with confirmed pulmonary tuberculosis as reference), but specificity was high (100% [91%\u2013100%]). The highest sensitivity was 33% (95% confidence interval, 15%\u201358%) among participants with HIV. The overall yield was 6.9% with 1 oral swab specimen and 7.2% with 2.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Use of the Xpert MTB\/RIF Ultra assay with oral swab specimens provides poor yield for microbiologic pulmonary tuberculosis confirmation in children.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/cid\/ciac332","type":"journal-article","created":{"date-parts":[[2022,5,5]],"date-time":"2022-05-05T07:16:01Z","timestamp":1651734961000},"page":"2145-2152","source":"Crossref","is-referenced-by-count":53,"title":["Oral Swab Specimens Tested With Xpert MTB\/RIF Ultra Assay for Diagnosis of Pulmonary Tuberculosis in Children: A Diagnostic Accuracy Study"],"prefix":"10.1093","volume":"75","author":[{"given":"Helen","family":"Cox","sequence":"first","affiliation":[{"name":"Division of Medical Microbiology, Department of Pathology, University of Cape Town , Cape Town , South Africa"},{"name":"Wellcome Centre for Infectious Disease Research, and Institute of Infectious Disease and Molecular Medicine, University of Cape Town , Cape Town , South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lesley","family":"Workman","sequence":"additional","affiliation":[{"name":"Department of Paediatrics and Child Health and South African Medical Research Council Unit on Child and Adolescent Health, University of Cape Town and Red Cross War Memorial Children\u2019s Hospital , Cape Town , South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lindy","family":"Bateman","sequence":"additional","affiliation":[{"name":"Department of Paediatrics and Child Health and South African Medical Research Council Unit on Child and Adolescent Health, University of Cape Town and Red Cross War Memorial Children\u2019s Hospital , Cape Town , South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zoe","family":"Franckling-Smith","sequence":"additional","affiliation":[{"name":"Department of Paediatrics and Child Health and South African Medical Research Council Unit on Child and Adolescent Health, University of Cape Town and Red Cross War Memorial Children\u2019s Hospital , Cape Town , South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margaretha","family":"Prins","sequence":"additional","affiliation":[{"name":"Department of Paediatrics and Child Health and South African Medical Research Council Unit on Child and Adolescent Health, University of Cape Town and Red Cross War Memorial Children\u2019s Hospital , Cape Town , South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juaneta","family":"Luiz","sequence":"additional","affiliation":[{"name":"Department of Paediatrics and Child Health and South African Medical Research Council Unit on Child and Adolescent Health, University of Cape Town and Red Cross War Memorial Children\u2019s Hospital , Cape Town , South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Judi","family":"Van Heerden","sequence":"additional","affiliation":[{"name":"Division of Medical Microbiology, Department of Pathology, University of Cape Town , Cape Town , South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lemese","family":"Ah Tow Edries","sequence":"additional","affiliation":[{"name":"Division of Medical Microbiology, Department of Pathology, University of Cape Town , Cape Town , South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samantha","family":"Africa","sequence":"additional","affiliation":[{"name":"Division of Medical Microbiology, Department of Pathology, University of Cape Town , Cape Town , South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Veronica","family":"Allen","sequence":"additional","affiliation":[{"name":"Division of Medical Microbiology, Department of Pathology, University of Cape Town , Cape Town , South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cynthia","family":"Baard","sequence":"additional","affiliation":[{"name":"Department of Paediatrics and Child Health and South African Medical Research Council Unit on Child and Adolescent Health, University of Cape Town and Red Cross War Memorial Children\u2019s Hospital , Cape Town , South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Widaad","family":"Zemanay","sequence":"additional","affiliation":[{"name":"Division of Medical Microbiology, Department of Pathology, University of Cape Town , Cape Town , South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark P","family":"Nicol","sequence":"additional","affiliation":[{"name":"Division of Medical Microbiology, Department of Pathology, University of Cape Town , Cape Town , South Africa"},{"name":"Division of Infection and Immunity, School of Biomedical Sciences, University of Western Australia , Perth , Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heather J","family":"Zar","sequence":"additional","affiliation":[{"name":"Department of Paediatrics and Child Health and South African Medical Research Council Unit on Child and Adolescent Health, University of Cape Town and Red Cross War Memorial Children\u2019s Hospital , Cape Town , South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2022,5,17]]},"reference":[{"key":"2022121911370681000_ciac332-B1","doi-asserted-by":"crossref","first-page":"e453","DOI":"10.1016\/S2214-109X(14)70245-1","article-title":"Burden of childhood tuberculosis in 22 high-burden 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