{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,26]],"date-time":"2026-02-26T21:57:07Z","timestamp":1772143027660,"version":"3.50.1"},"reference-count":30,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2026,2,9]],"date-time":"2026-02-09T00:00:00Z","timestamp":1770595200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"name":"Operational Research, State TB Cell, National Tuberculosis Elimination Programme, Odisha"},{"name":"Senior Research Associate, CSIR, New Delhi"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,2,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Diagnosis of paediatric pulmonary tuberculosis (PTB) continues to be a major challenge due to the inability to expectorate and paucibacillary nature of the disease. In endemic settings, the diagnosis of paediatric PTB depends mainly on clinical and radiological features as gastric aspirate (GA) is an unpleasant procedure and requires expertise as well as hospital admission. This hinders microbiological diagnosis and resistance detection. This study aims to evaluate the use of a less invasive, alternative specimen like stool for the microbiological confirmation of paediatric PTB.<\/jats:p>\n                  <jats:p>Gastric aspirate or induced sputum (IS) and stool samples (at least 2\u2009gm) samples were collected from children of age &amp;lt;14\u2009years old with suspected PTB admitted in the paediatric department. IS\/GA was tested as per National Tuberculosis Elimination Programme protocol by Xpert MTB\/RIF-Ultra assay. Processing of stool samples was standardized and appropriate protocol followed for Xpert MTB\/Rif-Ultra assay.<\/jats:p>\n                  <jats:p>A total of 104 pairs of samples were tested by Xpert-Ultra assay. Eighteen of 104 GA\/IS samples were positive; of which stool samples were positive in 15 cases. The bacterial load in 2 samples were low and very low in one. All GA\/IS with medium and high bacterial load were detected by Stool Xpert-Ultra assay, and stool Xpert assay was positive in five GA\/IS Xpert-Ultra negative samples.<\/jats:p>\n                  <jats:p>Stool can be used as an alternative sample for the diagnosis of paediatric PTB.<\/jats:p>","DOI":"10.1093\/tropej\/fmag008","type":"journal-article","created":{"date-parts":[[2026,1,28]],"date-time":"2026-01-28T12:45:17Z","timestamp":1769604317000},"source":"Crossref","is-referenced-by-count":0,"title":["Evaluation of stool as an alternative specimen for the diagnosis of paediatric pulmonary tuberculosis: a cross-sectional study"],"prefix":"10.1093","volume":"72","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0790-1448","authenticated-orcid":false,"given":"Sutapa","family":"Rath","sequence":"first","affiliation":[{"name":"Yashoda Hospital , Hyderabad, Telangana 500084,","place":["India"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Baijayantimala","family":"Mishra","sequence":"additional","affiliation":[{"name":"Department of Microbiology & PI State level VRDL, All India Institute of Medical Sciences , Bhubaneswar 751019, Odisha,","place":["India"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rashmi","family":"Ranjan Das","sequence":"additional","affiliation":[{"name":"Division of Pulmonology & Intensive Care, Department of Pediatrics, All India Institute of Medical Sciences , Bhubaneswar 751019, Odisha,","place":["India"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nishu","family":"Kaushik","sequence":"additional","affiliation":[{"name":"All India Institute of Medical Sciences, Department of Microbiology, Bhubaneswar 751019, Odisha,","place":["India"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Asha Prakash","family":"Mohapatra","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, PGIMER & Capital Hospital , Bhubaneswar, 751020,","place":["India"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Debiprasad","family":"Jena","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, SCB Medical College , Cuttack, 753007,","place":["India"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pravakar","family":"Mishra","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, SCB Medical College , Cuttack, 753007,","place":["India"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2026,2,26]]},"reference":[{"key":"2026022615581577400_fmag008-B1","doi-asserted-by":"crossref","first-page":"e898","DOI":"10.1016\/S2214-109X(17)30289-9","article-title":"The global burden of tuberculosis mortality in children: a mathematical modelling 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Module 5: Management of Tuberculosis in Children and Adolescents","author":"WHO","year":"2022"},{"key":"2026022615581577400_fmag008-B12","doi-asserted-by":"crossref","first-page":"812","DOI":"10.1128\/mBio.00812-17","article-title":"The new xpert MTB\/RIF ultra: improving detection of Mycobacterium tuberculosis and resistance to Rifampin in an assay suitable for point-of-care testing","volume":"8","author":"Chakravorty","year":"2017","journal-title":"mBio"},{"key":"2026022615581577400_fmag008-B13","doi-asserted-by":"publisher","first-page":"CD009593","DOI":"10.1128\/mBio.00812-17","article-title":"Xpert ultra versus Xpert MTB\/RIF for pulmonary tuberculosis and rifampicin resistance in adults with presumptive pulmonary tuberculosis","volume":"2","author":"Zifodya","year":"2021","journal-title":"Cochrane Database Syst Rev"},{"key":"2026022615581577400_fmag008-B14","author":"Paediatric TB Management Guideline National Tuberculosis Elimination Programme (NTEP), Government of India","year":"2022"},{"key":"2026022615581577400_fmag008-B15","author":"Revised National Tuberculosis Control Programme","year":"2017"},{"key":"2026022615581577400_fmag008-B16","doi-asserted-by":"publisher","first-page":"e0040621","DOI":"10.1128\/JCM.00406-21","article-title":"The simple One-Step (SOS) stool processing method for use with the Xpert MTB\/RIF assay for a child-friendly diagnosis of tuberculosis closer to the point of care","volume":"59","author":"de Haas","year":"2021","journal-title":"J Clin Microbiol."},{"key":"2026022615581577400_fmag008-B17","doi-asserted-by":"publisher","first-page":"100195","DOI":"10.1016\/j.jctube.2020.100195","article-title":"Evaluation of stool GeneXpert MTB\/RIF for the diagnosis of pulmonary tuberculosis among presumptive patients in Tanzania","volume":"21","author":"Ngadaya","year":"2020","journal-title":"J Clin Tuberc Other Mycobact Dis"},{"key":"2026022615581577400_fmag008-B18","doi-asserted-by":"publisher","first-page":"e0203063","DOI":"10.1371\/journal.pone.0203063","article-title":"Evaluation of Xpert MTB\/RIF assay for detection of Mycobacterium tuberculosis in stool samples of adults with pulmonary tuberculosis","volume":"13","author":"Rahman","year":"2018","journal-title":"PLoS One"},{"key":"2026022615581577400_fmag008-B19","volume-title":"Released 2019. 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