Symposium – Childhood TB: alternative sample types

Important progress is being made in Childhood TB diagnostics, with alternative sample types that are not painful or traumatizing. The latest developments will be presented at the Union World Conference during KNCV’s symposium ‘Improving access to laboratory-based diagnosis for young children: recent advances using stool and urine as alternative sample types’. With KNCV’s Petra de Haas as moderator and Edine Tiemersma as one of the speakers. Make sure to tune in on Thursday 22nd of October at 15.00 CET! 

KNCV is on the forefront, fighting for better access to TB diagnosis for children. We developed the revolutionary Simple-One-Step (SOS) stool method for Xpert MTB/RIF testing using minimal equipment. This can enable the identification of thousands of children with TB and multidrug-resistant TB (MDR-TB) disease – drastically reducing the numbers of children under five dying from TB.

One of the main challenges currently is that young children cannot spit up a sputum specimen, the primary sample used for TB laboratory diagnosis. Therefore, to collect sputum,  more complex and invasive procedures are used such as   gastric aspiration, in which a tube is brought into the child’s stomach via his or her nose. Such procedures are stressful and painful for the children and, in addition, rarely available at decentralized level in high burden countries.

The painless, affordable and simple SOS stool method was presented by KNCV during the 49th Union World Conference. Since the beginning of this year the WHO guidelines recommend the use of stool and urine as alternative samples.

In Ethiopia and Indonesia, KNCV is currently refining the Standard Operating Procedures (SOP’s) for wider use and is determining the robustness of the SOS stool method. This is done by comparing this method to the current routine procedure of the use of sputum (nasogastric aspiration) samples in combination with a clinical diagnosis. Children with presumptive TB at cooperating health care facilities leave both a sputum and a stool sample to be tested.

The KNCV SOS stool method uses the same buffer and cartridge as those used for the Xpert MTB/RIF sputum test. After a short training, laboratory staff can easily conduct this method.

Union World Conference Symposium

Thursday 22nd of October 2020
15:00 – 16:20: Improving access to laboratory-based diagnosis for young children: recent advances using stool and urine as alternative sample types
Online/virtual, Channel 4

While clinical diagnosis remains valuable, improving access to laboratory-based diagnosis for children with presumptive TB is critical to increase diagnostic certainty and ensure timely initiation on effective treatment, even more so in settings with high transmission of drug-resistant TB. Laboratory-based diagnosis in children is hampered by challenges in obtaining adequate specimens and sub-optimal performance of existing tests on pauci-bacillary specimens. Recently the World Health Organization recommended stool as a useful specimen to diagnose pulmonary paediatric TB and urine-based LF-LAM for children living with HIV. This session will review the latest evidence on the role of those alternative sample types for childhood TB.

15:00 – 15:05: Introduction
15:05 – 15:15: Closing the case detection gap in children with TB: WHO updates- Sabine Verkuijl
15:15 – 15:25: Utility of stool samples for microbiological confirmation of TB in children – Pamela Nabeta
15:25 – 15:35: Update on simple one step stool testing method and practical guidance on the best placement of this test in the diagnostic algorithm – Edine Tiemersma
15:35 – 15:45: Accuracy of a novel urine test, Fujifilm SILVAMP TB LAM, for the diagnosis of pulmonary TB in children Mark Nicol
15:45 – 15:55: Keynote : overview of where we are in childhood TB diagnosis Ben Marais
15:55 – 16:20: Q&A session

For more information on KNCV’s SOS stool method, contact edine.tiemersma@kncvtbc.org.

More on KNCV at the Union World Conference

KNCV has been fighting TB since its establishment in 1903. Over the past 117 years, the organization has acquired indispensable knowledge and experience in the field of effective TB control, resulting in pre-elimination in the Netherlands and significant contributions to global evidence generation, policy development and TB program implementation worldwide.

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