{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T20:42:24Z","timestamp":1788381744958,"version":"build-2803163510"},"reference-count":37,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,10,19]],"date-time":"2022-10-19T00:00:00Z","timestamp":1666137600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cell. Infect. Microbiol."],"abstract":"<jats:p>The research of childhood tuberculosis is inadequate in china. The cross-priming amplification (CPA) of specific DNA in clinical samples is increasingly adopted for the diagnosis of childhood tuberculosis. In this study, a multicenter research was performed to investigate the incidence and characteristics of childhood tuberculosis in suspected populations mainly by CPA method. 851 children suspected of tuberculosis were enrolled in seven centers across China. All samples were tested by a CPA method and 159 subjects were tested by Xpert MTB\/RIF and liquid culture method in parallel to assess the reliability of the CPA method. A positive result in any one of the three methods provided a definitive diagnosis of <jats:italic>Mycobacterium tuberculosis complex<\/jats:italic> (MTBC) infection. The MTBC-positive rate was 9.5% (81\/851) by the combined methods; 93.8% of the cases were detected by CPA technology (76\/81). The rate of pulmonary infection was significantly higher than that of extrapulmonary infection (7.1%, 60\/851 vs 2.5%, 21\/851; P &amp;lt; 0.001). Scrofula was the predominant type of extrapulmonary tuberculosis. The MTBC positive rates in 12-18-year-old group (middle school), was 28.4% (23\/81), higher than in those under-six-year-old (preschool; 39\/525) and the 6~11-year-old (primary school; 18\/235) groups combined (P &amp;lt; 0.001). The MTBC positive rate in patients with a clear history of tuberculosis exposure was significantly higher than in cases in which there was no history of tuberculosis contact(35.3%, 18\/51 vs 7.8%, 61\/782; P &amp;lt; 0.001). In conclusion, this multicenter investigation showed that pulmonary tuberculosis and extrapulmonary tuberculosis are not uncommon in children in China, with teenagers being particularly susceptible to infection. The incidence of pulmonary tuberculosis in children is higher than that of extrapulmonary tuberculosis. History of exposure to tuberculosis is a high risk factor for childhood tuberculosis.<\/jats:p>","DOI":"10.3389\/fcimb.2022.1018699","type":"journal-article","created":{"date-parts":[[2022,10,19]],"date-time":"2022-10-19T17:26:41Z","timestamp":1666200401000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Research of childhood tuberculosis in suspected populations by molecular methods: A multicenter study in China"],"prefix":"10.3389","volume":"12","author":[{"given":"Chunling","family":"Li","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shifu","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hui","family":"Yu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiangxia","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jikui","family":"Deng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hongmei","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chunzhen","family":"Hua","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhiqiang","family":"Zhuo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lei","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianhua","family":"Hao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Gao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hong","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ting","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hongmei","family":"Xu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chuanqing","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2022,10,19]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1590\/0037-8682-0205-2020","article-title":"The clinical and molecular diagnosis of childhood and adolescent pulmonary tuberculosis in referral centers","volume":"53","author":"Aurilio","year":"2020","journal-title":"Rev. Soc. Bras. Med. Trop."},{"key":"B2","doi-asserted-by":"publisher","first-page":"96","DOI":"10.1186\/s12879-020-4800-y","article-title":"Identification of subclinical tuberculosis in household contacts using exposure scores and contact investigations","volume":"20","author":"Bekken","year":"2020","journal-title":"BMC Infect. Dis."},{"key":"B3","doi-asserted-by":"publisher","first-page":"w20253","DOI":"10.4414\/smw.2020.20253","article-title":"Prevalence of tuberculosis in migrant children in Switzerland and relevance of current screening guidelines","volume":"150","author":"Boukamel","year":"2020","journal-title":"Swiss Med. Wkly"},{"key":"B4","doi-asserted-by":"publisher","first-page":"3106","DOI":"10.1128\/jcm.33.12.3106-3110.1995","article-title":"Diagnosis of tuberculosis by amplicor mycobacterium tuberculosis test: A multicenter study","volume":"33","author":"Carpentier","year":"1995","journal-title":"J. Clin. Microbiol."},{"key":"B5","doi-asserted-by":"publisher","first-page":"451","DOI":"10.1016\/S2213-2600(15)00095-8","article-title":"Xpert MTB\/RIF assay for the diagnosis of pulmonary tuberculosis in children: A systematic review and meta-analysis","volume":"3","author":"Detjen","year":"2015","journal-title":"Lancet Respir. Med."},{"key":"B6","doi-asserted-by":"publisher","first-page":"156","DOI":"10.1093\/aje\/kwv160","article-title":"Age- and sex-specific social contact patterns and incidence of mycobacterium tuberculosis infection","volume":"183","author":"Dodd","year":"2016","journal-title":"Am. J. Epidemiol."},{"key":"B7","doi-asserted-by":"publisher","first-page":"910","DOI":"10.3201\/eid2605.190574","article-title":"Systematic review and meta-analysis of sex differences in social contact patterns and implications for tuberculosis transmission and control","volume":"26","author":"Horton","year":"2020","journal-title":"Emerg. Infect. Dis."},{"key":"B8","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1128\/9781555819866.ch32","article-title":"Tuberculosis in infants and children","volume":"5","author":"Lamb","year":"2017","journal-title":"Microbiol. Spectr."},{"key":"B9","doi-asserted-by":"publisher","first-page":"S122","DOI":"10.1016\/s0929-693x(05)80027-2","article-title":"Extra-pulmonary tuberculosis in childhood","author":"Le Roux","year":"2005","journal-title":"Arch. Pediatr."},{"key":"B10","doi-asserted-by":"publisher","first-page":"1285","DOI":"10.5588\/ijtld.20.0391","article-title":"Childhood TB in China: Notification, characteristics and risk factors for outcome -2017","volume":"24","author":"Li","year":"2020","journal-title":"Int. J. Tuberc. Lung Dis."},{"key":"B11","first-page":"278","article-title":"The clinical epidemiology of childhood pulmonary tuberculosis: A critical review of literature from the pre-chemotherapy era","volume":"8","author":"Marais","year":"2004","journal-title":"Int. J. Tuberc. Lung Dis."},{"key":"B12","doi-asserted-by":"publisher","first-page":"973","DOI":"10.1016\/S0140-6736(20)30166-5","article-title":"The risk of tuberculosis in children after close exposure: A systematic review and individual-participant meta-analysis","volume":"395","author":"Martinez","year":"2020","journal-title":"Lancet"},{"key":"B13","doi-asserted-by":"publisher","first-page":"1005","DOI":"10.1016\/S0140-6736(14)60844-8","article-title":"Global, regional, and national incidence and mortality for HIV, tuberculosis, and malaria during 1990-2013: A systematic analysis for the global burden of disease study 2013","volume":"384","author":"Murray","year":"2014","journal-title":"Lancet"},{"key":"B14","first-page":"636","article-title":"Global epidemiology of childhood tuberculosis","volume":"8","author":"Nelson","year":"2004","journal-title":"Int. J. Tuberc. Lung Dis."},{"key":"B15","doi-asserted-by":"publisher","first-page":"428","DOI":"10.1016\/j.tube.2014.04.006","article-title":"A multicenter study of cross-priming amplification for tuberculosis diagnosis at peripheral level in China","volume":"94","author":"Ou","year":"2014","journal-title":"Tuberc. (Edinb)."},{"key":"B16","doi-asserted-by":"publisher","first-page":"457","DOI":"10.3201\/eid2503.180572","article-title":"Epidemiology of extrapulmonary tuberculosis among inpatients, China 2008-2017","volume":"25","author":"Pang","year":"2019","journal-title":"Emerg. Infect. Dis."},{"key":"B17","doi-asserted-by":"publisher","first-page":"1411","DOI":"10.1111\/jfd.13448","article-title":"Development of cross-priming amplification (CPA) combined with colorimetric and lateral flow dipstick visualization for scale drop disease virus (SDDV) detection","volume":"44","author":"Prasitporn","year":"2021","journal-title":"J. Fish Dis."},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.3389\/fmicb.2022.819654","article-title":"A novel cross-priming amplification-based assay for tuberculosis diagnosis in children using gastric aspirate","volume":"13","author":"Quan","year":"2022","journal-title":"Front. Microbiol."},{"key":"B19","doi-asserted-by":"publisher","first-page":"51","DOI":"10.4067\/S0716-10182020000100051","article-title":"Tuberculosis: A challenge in newborn care and how to deal with it. Update document","volume":"37","author":"Reyes","year":"2020","journal-title":"Rev. Chil. Infectol."},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2018.02946","article-title":"The wonder years: What can primary school children teach us about immunity to mycobacterium tuberculosis","volume":"9","author":"Seddon","year":"2018","journal-title":"Front. Immunol."},{"key":"B21","doi-asserted-by":"publisher","first-page":"1070","DOI":"10.1056\/NEJMe1008496","article-title":"Tuberculosis diagnosis\u2013time for a game change","volume":"363","author":"Small","year":"2010","journal-title":"N Engl. J. Med."},{"key":"B22","doi-asserted-by":"publisher","first-page":"e22015","DOI":"10.1097\/MD.0000000000022015","article-title":"Tuberculosis infection in children visiting friends and relatives in countries with high incidence of tuberculosis: A study protocol","volume":"99","author":"Soriano-Arandes","year":"2020","journal-title":"Med. (Baltimore)."},{"key":"B23","doi-asserted-by":"publisher","first-page":"101","DOI":"10.3855\/jidc.10952","article-title":"Tuberculosis outbreak among high school students in novi pazar, Serbia 2016: A retrospective-cohort study","volume":"13","author":"Stosic","year":"2019","journal-title":"J. Infect. Dev. Ctries."},{"key":"B24","doi-asserted-by":"publisher","first-page":"S184","DOI":"10.1086\/651490","article-title":"Pediatric tuberculosis: Global overview and challenges","author":"Swaminathan","year":"2010","journal-title":"Clin. Infect. Dis."},{"key":"B25","doi-asserted-by":"publisher","first-page":"743","DOI":"10.1007\/s00705-020-04526-5","article-title":"Development of a cross-priming isothermal amplification assay based on the glycoprotein b gene for instant and rapid detection of feline herpesvirus type 1","volume":"165","author":"Tan","year":"2020","journal-title":"Arch. Virol."},{"key":"B26","doi-asserted-by":"publisher","first-page":"101229","DOI":"10.1016\/j.rmcr.2020.101229","article-title":"Pulmonary tuberculosis presenting as lung abscess in a 10-month-Old infant","volume":"31","author":"Thadchanamoorthy","year":"2020","journal-title":"Respir. Med. Case Rep."},{"key":"B27","doi-asserted-by":"publisher","first-page":"893","DOI":"10.1016\/j.pcl.2017.03.010","article-title":"Tuberculosis in children","volume":"64","author":"Thomas","year":"2017","journal-title":"Pediatr. Clin. North Am."},{"key":"B28","doi-asserted-by":"publisher","first-page":"101713","DOI":"10.1016\/j.ttbdis.2021.101713","article-title":"Cross-priming amplification targeting the 18S rRNA gene for the rapid diagnosis of babesia bovis infection","volume":"12","author":"Wang","year":"2021","journal-title":"Ticks Tick Borne Dis."},{"key":"B29","doi-asserted-by":"publisher","first-page":"105","DOI":"10.3760\/cma.j.issn.1001-0939.2018.02.007","article-title":"(Comparison of the efficacies of cross priming amplification and RealAmp with XpertMTB\/RIF for the diagnosis of pulmonary tuberculosis at peripheral microscopic center)","volume":"41","author":"Wang","year":"2018","journal-title":"Zhonghua Jie He He Hu Xi Za Zhi."},{"key":"B30","unstructured":"Global tuberculosis report 20212021"},{"key":"B31","doi-asserted-by":"publisher","first-page":"827","DOI":"10.24425\/pjvs.2018.125597","article-title":"Comparison of loop-mediated isothermal amplification (LAMP) and cross-priming amplification (CPA) for detection of African swine fever virus","volume":"21","author":"Wo\u017aniakowski","year":"2018","journal-title":"Pol. J. Vet. Sci."},{"key":"B32","doi-asserted-by":"publisher","first-page":"38","DOI":"10.1186\/s12941-021-00443-w","article-title":"Comparative evaluation of six nucleic acid amplification kits for SARS-CoV-2 RNA detection","volume":"20","author":"Wu","year":"2021","journal-title":"Ann. Clin. Microbiol. Antimicrob."},{"key":"B33","doi-asserted-by":"publisher","first-page":"10946","DOI":"10.1038\/s41598-021-90479-x","article-title":"Rapid detection of avian leukosis virus subgroup J by cross-priming amplification","volume":"11","author":"Xiang","year":"2021","journal-title":"Sci. Rep."},{"key":"B34","doi-asserted-by":"publisher","first-page":"246","DOI":"10.1038\/srep00246","article-title":"Cross priming amplification: Mechanism and optimization for isothermal DNA amplification","volume":"2","author":"Xu","year":"2012","journal-title":"Sci. Rep."},{"key":"B35","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0230881","article-title":"Establishment and application of isothermal amplification techniques for the detection of heat-stable I enterotoxin of enterotoxigenic escherichia coli","volume":"15","author":"Zhai","year":"2020","journal-title":"PloS One"},{"key":"B36","doi-asserted-by":"publisher","first-page":"1530","DOI":"10.1080\/22221751.2021.1959271","article-title":"EasyNAT MTC assay: A simple, rapid, and low-cost cross-priming amplification method for the detection of mycobacterium tuberculosis suitable for point-of-care testing","volume":"10","author":"Zhang","year":"2021","journal-title":"Emerg. Microbes Infect."},{"key":"B37","doi-asserted-by":"publisher","DOI":"10.1128\/spectrum.02602-21","article-title":"Evaluation of aptamer fluorescence microscopy in the diagnosis of pulmonary tuberculosis","author":"Zheng","year":"2022","journal-title":"Microbiol. Spectr."}],"container-title":["Frontiers in Cellular and Infection Microbiology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcimb.2022.1018699\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,10,19]],"date-time":"2022-10-19T17:26:47Z","timestamp":1666200407000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcimb.2022.1018699\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,10,19]]},"references-count":37,"alternative-id":["10.3389\/fcimb.2022.1018699"],"URL":"https:\/\/doi.org\/10.3389\/fcimb.2022.1018699","relation":{},"ISSN":["2235-2988"],"issn-type":[{"value":"2235-2988","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,10,19]]},"article-number":"1018699"}}