Nasopharyngeal aspirates and stool sample collection for molecular tuberculosis testing in children with severe pneumonia - a mixed methods study
Abstract
Background: Child-friendly sample collection methods are needed to improve microbiological tuberculosis diagnosis in children. We assessed the feasibility, diagnostic yield, safety, tolerability, and acceptability of nasopharyngeal aspirates (NPA) and stool sample collection for XpertMTB/RIF Ultra (Ultra) testing in children 3 years. Individual interviews investigated nurses and parents/caregivers perceptions and experiences of both procedures. Results: Of 542 children enrolled, 541 (99.8%) and 423 (75.5%) had NPA and stool samples successfully collected, respectively; 8 (1.5%) had positive Ultra on any sample, 8 (1.5%) on NPA, and 3 (0.6%) on stool samples. Nurses reported that NPA was difficult to collect in 27 (5.0%) children. 130 (24%) children had bloodstained NPA samples and <5% experienced transient heart rate deceleration, digestive or respiratory distress during NPA. Median nurse-assessed tolerability scores were 1/10 [0,3] before and 5/10 [2,6] during NPA. Although most respondents perceived NPA as painful, all appreciated that NPA aimed to improve child health. Nurses reported that NPA and stool collection was quicker, less invasive than gastric aspiration. Parents/caregivers trusted nurses skills and valued the novelty of NPA. All respondents easily engaged in stool collection, but were frustrated to depend on children passing stool. Nurses underlined that continuous staff training and mentoring would sustain feasibility and self-efficacy in obtaining adequate…
How strong is the evidence?
Evidence Hub reads this as a cross-sectional, done in people. Its evidence level is 4 of 5 (Low · observational). Observational designs can show an association but not prove cause. Reported size: 542 participants or records.
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