{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,22]],"date-time":"2026-03-22T11:53:19Z","timestamp":1774180399436,"version":"3.50.1"},"reference-count":43,"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"}],"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>Diagnosing tuberculosis (TB) in children is challenging due to non-specific symptoms, paucibacillary disease, and difficulty producing sputum. Chest X-rays (CXRs), though widely used, are often inaccessible in low-resource settings and involve radiation. Ultrasound (US) is a radiation-free, portable, and potentially low-cost alternative that can detect pulmonary and extrapulmonary TB features. However, its diagnostic accuracy in paediatric TB remains unclear. This systematic review and meta-analysis assessed US diagnostic performance for paediatric TB across anatomical sites. Following PRISMA-DTA guidelines, we searched five databases through May 2025. Studies were included if they involved children under 15 with presumptive TB and reported US diagnostic accuracy data. Data extraction, quality assessment (QUADAS-2), and meta-analyses using a bivariate random-effects model were conducted. Graham\u2019s TB classification served as the reference standard. CXR was used as a comparator where available, with agreement assessed via Cohen\u2019s kappa. Of 17\u00a0019 records, 7 studies involving 945 children met inclusion criteria. Pooled US sensitivity was 52% (95% CI: 46\u201358%), and specificity was 76% (95% CI: 67\u201383%). US showed high specificity but low sensitivity across most features, including abdominal lymphadenopathy and pericardial effusion; pleural effusion had slightly higher sensitivity (18%). Agreement with CXR was moderate (kappa 0.24\u20130.42). Variability in US protocols, operator skills, and reference standards limited generalizability. Only one study had low risk of bias across all QUADAS-2 domains. US is a promising adjunct for paediatric TB diagnosis in resource-limited settings, but standardization and validation are needed to improve its standalone utility.<\/jats:p>","DOI":"10.1093\/tropej\/fmag021","type":"journal-article","created":{"date-parts":[[2026,3,22]],"date-time":"2026-03-22T11:12:06Z","timestamp":1774177926000},"source":"Crossref","is-referenced-by-count":0,"title":["A systematic review and meta-analysis of the diagnostic accuracy of ultrasound in the diagnosis of paediatric tuberculosis"],"prefix":"10.1093","volume":"72","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7190-6016","authenticated-orcid":false,"given":"Isabelle","family":"Munyangaju","sequence":"first","affiliation":[{"name":"ISGlobal , Barcelona, 08036,","place":["Spain"]},{"name":"Facultat de Medicina i Ci\u00e8ncies de la Salut, Universitat de Barcelona (UB) , Barcelona, 08036,","place":["Spain"]},{"name":"Tinpswalo Association: Vincentia Association to Fight AIDS and TB"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luc\u00eda","family":"Carratal\u00e0-Castro","sequence":"additional","affiliation":[{"name":"ISGlobal , Barcelona, 08036,","place":["Spain"]},{"name":"Facultat de Medicina i Ci\u00e8ncies de la Salut, Universitat de Barcelona (UB) , Barcelona, 08036,","place":["Spain"]},{"name":"Centro de Investiga\u00e7\u00e3o em Sa\u00fade de Manhi\u00e7a (CISM) , Maputo, 1929,","place":["Mozambique"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dulce","family":"Os\u00f3rio","sequence":"additional","affiliation":[{"name":"Tinpswalo Association: Vincentia Association to Fight AIDS and TB"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jacob","family":"Bigio","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Biostatistics and Occupational Health, McGill University , Montreal, Quebec, H3A 1Y7,","place":["Canada"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kondwelani John","family":"Mateyo","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, University Teaching Hospital , Lusaka, 32379,","place":["Zambia"]},{"name":"Zambart, University of Zambia-Ridgeway Campus , Lusaka,","place":["Zambia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5657-0980","authenticated-orcid":false,"given":"Bryan J","family":"Vonasek","sequence":"additional","affiliation":[{"name":"College of Osteopathic Medicine, Michigan State University, Michigan, 48824, USA"},{"name":"Department of Paediatrics and Child Health, Kamuzu University of Health Sciences , Blantyre, 360,","place":["Malawi"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8567-2639","authenticated-orcid":false,"given":"Danilo","family":"Buonsenso","sequence":"additional","affiliation":[{"name":"Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS , Rome, 00168,","place":["Italy"]},{"name":"Area Pediatrica, Dipartimento di Scienze della Vita e Sanit\u00e0 Pubblica, Universit\u00e0 Cattolica del Sacro Cuore , Rome, 00168,","place":["Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0875-7596","authenticated-orcid":false,"given":"Quique","family":"Bassat","sequence":"additional","affiliation":[{"name":"ISGlobal , Barcelona, 08036,","place":["Spain"]},{"name":"Facultat de Medicina i Ci\u00e8ncies de la Salut, Universitat de Barcelona (UB) , Barcelona, 08036,","place":["Spain"]},{"name":"Centro de Investiga\u00e7\u00e3o em Sa\u00fade de Manhi\u00e7a (CISM) , Maputo, 1929,","place":["Mozambique"]},{"name":"ICREA , Barcelona 08010,","place":["Spain"]},{"name":"Institut Cl\u00ednic de Medicina I Dermatologia, Hospital Cl\u00ednic de Barcelona , Barcelona, 08036,","place":["Spain"]},{"name":"Pediatrics Department, Hospital Sant Joan de D\u00e9u, Universitat de Barcelona, Esplugues , Barcelona, 08950,","place":["Spain"]},{"name":"CIBER de Epidemiolog\u00eda y Salud P\u00fablica, Instituto de Salud Carlos III , Madrid, 28029,","place":["Spain"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xavier","family":"Serres-Cr\u00e9ixams","sequence":"additional","affiliation":[{"name":"Radiology Department, Vall d\u2019Hebron Hospital , Barcelona, 08035","place":["Spain"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Isabelle","family":"Thierry-Chef","sequence":"additional","affiliation":[{"name":"ISGlobal , Barcelona, 08036,","place":["Spain"]},{"name":"Facultat de Medicina i Ci\u00e8ncies de la Salut, Universitat de Barcelona (UB) , Barcelona, 08036,","place":["Spain"]},{"name":"Autorit\u00e9 de s\u00fbret\u00e9 nucl\u00e9aire et de radioprotection , 92260,","place":["France"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alberto","family":"Garcia-Basteiro","sequence":"additional","affiliation":[{"name":"ISGlobal , Barcelona, 08036,","place":["Spain"]},{"name":"Facultat de Medicina i Ci\u00e8ncies de la Salut, Universitat de Barcelona (UB) , Barcelona, 08036,","place":["Spain"]},{"name":"Centro de Investiga\u00e7\u00e3o em Sa\u00fade de Manhi\u00e7a (CISM) , Maputo, 1929,","place":["Mozambique"]},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Enfermedades Infecciosas , Madrid, 28029,","place":["Spain"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Madhukar","family":"Pai","sequence":"additional","affiliation":[{"name":"McGill International TB Centre , Montreal, Quebec, H4A 3S5,","place":["Canada"]},{"name":"Epidemiology and Biostats, McGill University , Montreal, Quebec, H3A 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