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Stool testing for pulmonary TB diagnosis in adults

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BACKGROUND: Mycobacterium tuberculosis is acid-fast and able to survive in the gastrointestinal tract. Thus, bacteria can be found in stool if sputum is swallowed. In this study, the accuracy of different diagnostic stool methods (microscopy, polymerase chain reaction PCR and culture) among adults with pulmonary TB (PTB) were assessed and compared with sputum culture.

METHODS: Embase and PubMed were searched to identify studies with data on stool testing among patients with clinically presumed or microbiologically verified PTB.

RESULTS: Thirteen relevant studies were included. A pooled sensitivity of one or more of the three TB identifying methods was 79.1% (95% CI 61.5–92.5). The sensitivity of stool microscopy, PCR and culture was respectively 41.1% (95%CI 24.9–58.2), 89.7% (95% CI 81.4–95.9) and 38.0% (95% CI 26.2–50.6). The heterogeneity of the studies included was high.

CONCLUSION: Our review findings indicate that the analysis of stool specimens as part of PTB diagnostics is useful. PCR methods were particularly helpful in detecting a substantial proportion of patients with PTB.

Keywords: Mycobacterium tuberculosis; PCR; diagnostic methods; faeces; sensitivity

Document Type: Research Article

Affiliations: 1: Department of Infectious Diseases, Aarhus University Hospital, Aarhus University, Aarhus, Denmark 2: Department of Infectious Diseases, Aarhus University Hospital, Aarhus University, Aarhus, Denmark, Department of Public Health, Center for Global Health (GloHAU), Aarhus University, Aarhus, Denmark

Publication date: June 1, 2022

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  • The International Journal of Tuberculosis and Lung Disease (IJTLD) is for clinical research and epidemiological studies on lung health, including articles on TB, TB-HIV and respiratory diseases such as COVID-19, asthma, COPD, child lung health and the hazards of tobacco and air pollution. Individuals and institutes can subscribe to the IJTLD online or in print – simply email us at [email protected] for details.

    The IJTLD is dedicated to understanding lung disease and to the dissemination of knowledge leading to better lung health. To allow us to share scientific research as rapidly as possible, the IJTLD is fast-tracking the publication of certain articles as preprints prior to their publication. Read fast-track articles.

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