{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,15]],"date-time":"2026-01-15T08:21:55Z","timestamp":1768465315376,"version":"3.49.0"},"reference-count":0,"publisher":"International Union Against Tuberculosis and Lung Disease","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["int j tuberc lung dis"],"published-print":{"date-parts":[[2025,2,1]]},"abstract":"<jats:p>&lt;sec&gt;&lt;title&gt;BACKGROUND&lt;\/title&gt;We describe our approach and experience with the routine implementation of stool-based Xpert MTB\/RIF Ultra (Xpert) testing for the diagnosis of childhood TB in Zambia.&lt;\/sec&gt;&lt;sec&gt;&lt;title&gt;METHODS&lt;\/title&gt;We\n conducted a method validation and subsequently introduced stool as an alternative sample for routine Xpert testing for children and critically ill adults. We reviewed the impact of stool-based Xpert testing during the first 18 months of routine implementation.&lt;\/sec&gt;&lt;sec&gt;&lt;title&gt;RESULTS&lt;\/title&gt;The\n method validation showed 98.0% (95% CI 92.9\u201399.4) agreement between Xpert results on sputum\/gastric aspirate (GA) and stool specimens. During 18 months of routine implementation, 16,210 stool samples were tested, yielding 157 TB cases in children, including five rifampicin (RIF) resistant\n cases, and 45 cases in critically ill adults. In children aged 0\u20134 years, 10,288 stool samples were tested compared to 2,459 GA samples in the same period. Childhood TB notifications and the bacteriological confirmation rate increased by 30% and 53%, respectively, in 2021 compared to\n 2020.&lt;\/sec&gt;&lt;sec&gt;&lt;title&gt;CONCLUSION&lt;\/title&gt;The routine implementation of stool testing provided access to Xpert testing for children who could not produce sputum or have GA collected, contributing to increased bacteriological confirmation of TB in children. For\n critically ill adults with difficulty expectorating sputum, it facilitated a rapid test result.&lt;\/sec&gt;<\/jats:p>","DOI":"10.5588\/ijtld.24.0349","type":"journal-article","created":{"date-parts":[[2025,2,1]],"date-time":"2025-02-01T04:53:02Z","timestamp":1738385582000},"page":"75-79","source":"Crossref","is-referenced-by-count":3,"title":["Stool-based Xpert testing for diagnosis of TB in children and critically ill adults"],"prefix":"10.5588","volume":"29","author":[{"given":"W.","family":"Mwanza","sequence":"first","affiliation":[{"name":"Ministry of Health, Lusaka, Zambia;, USAID-STAR Project, Washington DC, USA;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M.","family":"Lutinala","sequence":"additional","affiliation":[{"name":"PATH, Lusaka, Zambia;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"K.","family":"Mundia","sequence":"additional","affiliation":[{"name":"Ministry of Health, Lusaka, Zambia;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"E.","family":"Klinkenberg","sequence":"additional","affiliation":[{"name":"Independent Consultant, Connect TB, The Hague, the Netherlands;, Department of Global Health, Amsterdam University Medical Centers, Amsterdam, the Netherlands;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"P.","family":"de Haas","sequence":"additional","affiliation":[{"name":"KNCV Tuberculosis Foundation, the Hague, the Netherlands;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M.","family":"Kabaso","sequence":"additional","affiliation":[{"name":"Ministry of Health, Lusaka, Zambia;, USAID-STAR Project, Washington DC, USA;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"K.","family":"Zimba","sequence":"additional","affiliation":[{"name":"USAID, Lusaka, Zambia;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C.","family":"Chabala","sequence":"additional","affiliation":[{"name":"University Teaching Hospital, Children\u2019s Hospital, Lusaka, Zambia."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"B.","family":"Tambatamba","sequence":"additional","affiliation":[{"name":"Ministry of Health, Lusaka, Zambia;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M.","family":"Angel","sequence":"additional","affiliation":[{"name":"Ministry of Health, Lusaka, Zambia;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"P.","family":"Lungu","sequence":"additional","affiliation":[{"name":"Ministry of Health, Lusaka, Zambia;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"K.","family":"Lishimpi","sequence":"additional","affiliation":[{"name":"Ministry of Health, Lusaka, Zambia;"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"3554","container-title":["The International Journal of Tuberculosis and Lung Disease"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ingentaconnect.com\/content\/iuatld\/ijtld\/2025\/00000029\/00000002\/art00005","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,2,1]],"date-time":"2025-02-01T04:53:09Z","timestamp":1738385589000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ingentaconnect.com\/content\/10.5588\/ijtld.24.0349"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,2,1]]},"references-count":0,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2025,2,1]]}},"alternative-id":["1027-3719(20250201)29:2L.75;1-"],"URL":"https:\/\/doi.org\/10.5588\/ijtld.24.0349","relation":{},"ISSN":["1027-3719"],"issn-type":[{"value":"1027-3719","type":"print"}],"subject":[],"published":{"date-parts":[[2025,2,1]]}}}