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• W3045976532 abstract "Globally, children under 15 years represent approximately 12% of new tuberculosis cases, but 16% of the estimated 1.4 million deaths. This higher share of mortality highlights the urgent need to develop strategies to improve case detection in this age group and identify children without tuberculosis disease who should be considered for tuberculosis preventive treatment. One such strategy is systematic screening for tuberculosis in high-risk groups.To estimate the sensitivity and specificity of the presence of one or more tuberculosis symptoms, or symptom combinations; chest radiography (CXR); Xpert MTB/RIF; Xpert Ultra; and combinations of these as screening tests for detecting active pulmonary childhood tuberculosis in the following groups. - Tuberculosis contacts, including household contacts, school contacts, and other close contacts of a person with infectious tuberculosis. - Children living with HIV. - Children with pneumonia. - Other risk groups (e.g. children with a history of previous tuberculosis, malnourished children). - Children in the general population in high tuberculosis burden settings.We searched six databases, including the Cochrane Central Register of Controlled Trials, MEDLINE, and Embase, on 14 February 2020 without language restrictions and contacted researchers in the field.Cross-sectional and cohort studies where at least 75% of children were aged under 15 years. Studies were eligible if conducted for screening rather than diagnosing tuberculosis. Reference standards were microbiological (MRS) and composite reference standard (CRS), which may incorporate symptoms and CXR.Two review authors independently extracted data and assessed study quality using QUADAS-2. We consolidated symptom screens across included studies into groups that used similar combinations of symptoms as follows: one or more of cough, fever, or poor weight gain and one or more of cough, fever, or decreased playfulness. For combination of symptoms, a positive screen was the presence of one or more than one symptom. We used a bivariate model to estimate pooled sensitivity and specificity with 95% confidence intervals (CIs) and performed analyses separately by reference standard. We assessed certainty of evidence using GRADE.Nineteen studies assessed the following screens: one symptom (15 studies, 10,097 participants); combinations of symptoms (12 studies, 29,889 participants); CXR (10 studies, 7146 participants); and Xpert MTB/RIF (2 studies, 787 participants). Several studies assessed more than one screening test. No studies assessed Xpert Ultra. For 16 studies (84%), risk of bias for the reference standard domain was unclear owing to concern about incorporation bias. Across other quality domains, risk of bias was generally low. Symptom screen (verified by CRS) One or more of cough, fever, or poor weight gain in tuberculosis contacts (4 studies, tuberculosis prevalence 2% to 13%): pooled sensitivity was 89% (95% CI 52% to 98%; 113 participants; low-certainty evidence) and pooled specificity was 69% (95% CI 51% to 83%; 2582 participants; low-certainty evidence). Of 1000 children where 50 have pulmonary tuberculosis, 339 would be screen-positive, of whom 294 (87%) would not have pulmonary tuberculosis (false positives); 661 would be screen-negative, of whom five (1%) would have pulmonary tuberculosis (false negatives). One or more of cough, fever, or decreased playfulness in children aged under five years, inpatient or outpatient (3 studies, tuberculosis prevalence 3% to 13%): sensitivity ranged from 64% to 76% (106 participants; moderate-certainty evidence) and specificity from 37% to 77% (2339 participants; low-certainty evidence). Of 1000 children where 50 have pulmonary tuberculosis, 251 to 636 would be screen-positive, of whom 219 to 598 (87% to 94%) would not have pulmonary tuberculosis; 364 to 749 would be screen-negative, of whom 12 to 18 (2% to 3%) would have pulmonary tuberculosis. One or more of cough, fever, poor weight gain, or tuberculosis close contact (World Health Organization four-symptom screen) in children living with HIV, outpatient (2 studies, tuberculosis prevalence 3% and 8%): pooled sensitivity was 61% (95% CI 58% to 64%; 1219 screens; moderate-certainty evidence) and pooled specificity was 94% (95% CI 86% to 98%; 201,916 screens; low-certainty evidence). Of 1000 symptom screens where 50 of the screens are on children with pulmonary tuberculosis, 88 would be screen-positive, of which 57 (65%) would be on children who do not have pulmonary tuberculosis; 912 would be screen-negative, of which 19 (2%) would be on children who have pulmonary tuberculosis. CXR (verified by CRS) CXR with any abnormality in tuberculosis contacts (8 studies, tuberculosis prevalence 2% to 25%): pooled sensitivity was 87% (95% CI 75% to 93%; 232 participants; low-certainty evidence) and pooled specificity was 99% (95% CI 68% to 100%; 3281 participants; low-certainty evidence). Of 1000 children, where 50 have pulmonary tuberculosis, 63 would be screen-positive, of whom 19 (30%) would not have pulmonary tuberculosis; 937 would be screen-negative, of whom 6 (1%) would have pulmonary tuberculosis. Xpert MTB/RIF (verified by MRS) Xpert MTB/RIF, inpatient or outpatient (2 studies, tuberculosis prevalence 1% and 4%): sensitivity was 43% and 100% (16 participants; very low-certainty evidence) and specificity was 99% and 100% (771 participants; moderate-certainty evidence). Of 1000 children, where 50 have pulmonary tuberculosis, 31 to 69 would be Xpert MTB/RIF-positive, of whom 9 to 19 (28% to 29%) would not have pulmonary tuberculosis; 969 to 931 would be Xpert MTB/RIF-negative, of whom 0 to 28 (0% to 3%) would have tuberculosis. Studies often assessed more symptoms than those included in the index test and symptom definitions varied. These differences complicated data aggregation and may have influenced accuracy estimates. Both symptoms and CXR formed part of the CRS (incorporation bias), which may have led to overestimation of sensitivity and specificity.We found that in children who are tuberculosis contacts or living with HIV, screening tests using symptoms or CXR may be useful, but our review is limited by design issues with the index test and incorporation bias in the reference standard. For Xpert MTB/RIF, we found insufficient evidence regarding screening accuracy. Prospective evaluations of screening tests for tuberculosis in children will help clarify their use. In the meantime, screening strategies need to be pragmatic to address the persistent gaps in prevention and case detection that exist in resource-limited settings." @default.
• W3045976532 created "2020-08-03" @default.
• W3045976532 creator A5007956897 @default.
• W3045976532 creator A5024438276 @default.
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• W3045976532 creator A5043339911 @default.
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• W3045976532 creator A5054833656 @default.
• W3045976532 creator A5077929959 @default.
• W3045976532 creator A5091649890 @default.
• W3045976532 date "2021-06-28" @default.
• W3045976532 modified "2023-10-03" @default.
• W3045976532 title "Screening tests for active pulmonary tuberculosis in children" @default.
• W3045976532 cites W1136382591 @default.
• W3045976532 cites W129324069 @default.
• W3045976532 cites W1521934058 @default.
• W3045976532 cites W1522670941 @default.
• W3045976532 cites W1543385455 @default.
• W3045976532 cites W1577812786 @default.
• W3045976532 cites W1835427949 @default.
• W3045976532 cites W1918241676 @default.
• W3045976532 cites W1968038365 @default.
• W3045976532 cites W1982392575 @default.
• W3045976532 cites W1986236876 @default.
• W3045976532 cites W1986785372 @default.
• W3045976532 cites W1992309395 @default.
• W3045976532 cites W1992521482 @default.
• W3045976532 cites W1994158325 @default.
• W3045976532 cites W1994225104 @default.
• W3045976532 cites W2000322027 @default.
• W3045976532 cites W2001728623 @default.
• W3045976532 cites W2004163473 @default.
• W3045976532 cites W2015484303 @default.
• W3045976532 cites W2016434124 @default.
• W3045976532 cites W2017205679 @default.
• W3045976532 cites W2020786027 @default.
• W3045976532 cites W2024642014 @default.
• W3045976532 cites W2027040780 @default.
• W3045976532 cites W2046044306 @default.
• W3045976532 cites W2048652276 @default.
• W3045976532 cites W2051176634 @default.
• W3045976532 cites W2063332046 @default.
• W3045976532 cites W2065278501 @default.
• W3045976532 cites W2066810624 @default.
• W3045976532 cites W2070371765 @default.
• W3045976532 cites W2073760292 @default.
• W3045976532 cites W2076497274 @default.
• W3045976532 cites W2078278819 @default.
• W3045976532 cites W2079431949 @default.
• W3045976532 cites W2079709455 @default.
• W3045976532 cites W2083389058 @default.
• W3045976532 cites W2085448630 @default.
• W3045976532 cites W2088906993 @default.
• W3045976532 cites W2091801434 @default.
• W3045976532 cites W2093547008 @default.
• W3045976532 cites W2096652878 @default.
• W3045976532 cites W2098713638 @default.
• W3045976532 cites W2102332285 @default.
• W3045976532 cites W2106056202 @default.
• W3045976532 cites W2107638293 @default.
• W3045976532 cites W2108687073 @default.
• W3045976532 cites W2109686379 @default.
• W3045976532 cites W2115253345 @default.
• W3045976532 cites W2115812993 @default.
• W3045976532 cites W2117049630 @default.
• W3045976532 cites W2117265840 @default.
• W3045976532 cites W2121327992 @default.
• W3045976532 cites W2123300483 @default.
• W3045976532 cites W2126727011 @default.
• W3045976532 cites W2129152887 @default.
• W3045976532 cites W2135400982 @default.
• W3045976532 cites W2139379706 @default.
• W3045976532 cites W2141090053 @default.
• W3045976532 cites W2141238725 @default.
• W3045976532 cites W2152672472 @default.
• W3045976532 cites W2156098321 @default.
• W3045976532 cites W2157203477 @default.
• W3045976532 cites W2159480543 @default.
• W3045976532 cites W2160202077 @default.
• W3045976532 cites W2160846407 @default.
• W3045976532 cites W2163833955 @default.
• W3045976532 cites W2166123535 @default.
• W3045976532 cites W2167797754 @default.
• W3045976532 cites W2169510674 @default.
• W3045976532 cites W2170107823 @default.
• W3045976532 cites W2170572125 @default.
• W3045976532 cites W2170855601 @default.
• W3045976532 cites W2171680817 @default.
• W3045976532 cites W2177338691 @default.
• W3045976532 cites W2177899202 @default.
• W3045976532 cites W2283634919 @default.
• W3045976532 cites W2300781968 @default.
• W3045976532 cites W2306073280 @default.
• W3045976532 cites W2327841741 @default.
• W3045976532 cites W24040743 @default.
• W3045976532 cites W2410129096 @default.
• W3045976532 cites W2423366668 @default.
• W3045976532 cites W246286872 @default.
• W3045976532 cites W2477791837 @default.

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