TITLE:
Addressing Diagnostic Gaps in Paediatric Tuberculosis in the DRC: Insights from the Use of GeneXpert on Stool Specimens
AUTHORS:
Jude Lumu Lukusa, Nsimba Patrick Kinkani, Matota Angèle Shoma, Nkodila Aliocha, Ngwala Philippe Lukanu
KEYWORDS:
GeneXpert-Ultra Test, Stool Samples, Children, DRC
JOURNAL NAME:
Open Journal of Pediatrics,
Vol.15 No.5,
September
18,
2025
ABSTRACT: Background: Diagnosing paediatric tuberculosis (TB) remains challenging, partly because they are often unable to produce sputum samples. The use of stool samples with the Xpert MTB/RIF Ultra test for diagnosing paediatric pulmonary TB has already been implemented in several countries; however, this method remains very limited in the Democratic Republic of the Congo (DRC). The objective of this study was to estimate the prevalence of tuberculosis among children under 10 years of age using the GeneXpert test on stool samples in Tanganyika province. Methods: This was a retrospective cross-sectional study including 91 children under the age of 10 who were suspected of having tuberculosis. These children underwent TB screening using the GeneXpert test on stool samples collected in healthcare facilities located in five health zones of Tanganyika province. Sociodemographic and biological characteristics were analyzed. Results: The median age of the children was 24 months, with no sex predominance (sex ratio 1M:1F). The prevalence of pulmonary TB detected by the GeneXpert test on stool samples was 15.4% (95% CI: 12.3 - 18.6). Among the 14 positive samples, 78.6% were drug-sensitive, 14.3% were drug-resistant, and 7.1% were classified as trace results. TB prevalence was significantly higher among girls (p = 0.016) and malnourished children (p Conclusion: This study demonstrates that the GeneXpert-Ultra test on stool samples is a viable alternative to sputum testing in children who are unable to spontaneously produce expectorated samples and would otherwise require invasive procedures to obtain specimens for TB diagnosis.