Update on laboratory diagnosis of pediatric tuberculosis: New and more rapid methods

The major challenge of pediatric pulmonary TB (PPTB) is establishing an accurate diagnosis. Less than 15% of cases are sputum AFB smear positive and culture yields are 30-40%. Induced sputum, nasopharyngeal aspirate, early morning gastric aspiration or lavage can give a better yield. Culture on Lowenstein-Jensen medium is considered to be gold standard; however, liquid culture systems (BACTEC and MGIT) are more rapid and sensitive to diagnose active TB and drug susceptibility. MODS assay is faster than solid culture with simultaneous DST and is inexpensive. Nevertheless, it requires trained personnel, is labour intensive and lacks information for children. NAATs like line probe assay, Genotype MTBDRplus, GeneXpert device, TB-LAMP for diagnosing active TB and DST are fast, robust, fully automated, easy…