Exhaled breath analysis: A promising triage test for tuberculosis in young children

IF 2.8 3区医学 Q3 IMMUNOLOGY Tuberculosis Pub Date : 2024-09-10 DOI:10.1016/j.tube.2024.102566

Else M. Bijker , Jonathan P. Smith , Walter Mchembere , Kimberly D. McCarthy , Henny Oord , Jan-Willem Gerritsen , Eleanor S. Click , Kevin Cain , Rinn Song

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Abstract

The diagnosis of paediatric pulmonary tuberculosis is difficult, especially in young infants who cannot expectorate sputum spontaneously. Breath testing has shown promise in diagnosing respiratory tract infections, but data on paediatric tuberculosis are limited.

We performed a prospective cross-sectional study in Kenya in children younger than five years with symptoms of tuberculosis. We analysed exhaled breath with a hand-held battery-powered nose device. For data analysis, machine learning was applied using samples classified as positive (microbiologically confirmed) or negative (unlikely tuberculosis) to assess diagnostic accuracy.

Breath analysis was performed in 118 children. The area under the curve of the optimal model was 0.73. At a sensitivity of 86 % (CI 62–96 %), this resulted in a specificity of 42 % (95 % CI 30–55 %).

Exhaled breath analysis shows promise as a triage test for TB in young children, although the WHO target product characteristics were not met.

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呼气分析：有望成为幼儿结核病分诊测试的方法

小儿肺结核的诊断十分困难，尤其是对于无法自主排痰的幼儿。呼吸测试在诊断呼吸道感染方面已显示出良好的前景，但有关小儿肺结核的数据却十分有限。我们使用手持电池供电的鼻装置分析呼出的气体。在进行数据分析时，我们采用了机器学习方法，将样本分为阳性（微生物确诊）和阴性（不可能是肺结核）两类，以评估诊断的准确性。最佳模型的曲线下面积为 0.73。在灵敏度为 86 %（CI 62-96%）的情况下，特异性为 42 %（95 % CI 30-55%）。

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来源期刊

Tuberculosis 医学-呼吸系统

CiteScore

4.60

自引率

3.10%

发文量

审稿时长

49 days

期刊介绍： Tuberculosis is a speciality journal focusing on basic experimental research on tuberculosis, notably on bacteriological, immunological and pathogenesis aspects of the disease. The journal publishes original research and reviews on the host response and immunology of tuberculosis and the molecular biology, genetics and physiology of the organism, however discourages submissions with a meta-analytical focus (for example, articles based on searches of published articles in public electronic databases, especially where there is lack of evidence of the personal involvement of authors in the generation of such material). We do not publish Clinical Case-Studies. Areas on which submissions are welcomed include: -Clinical TrialsDiagnostics- Antimicrobial resistance- Immunology- Leprosy- Microbiology, including microbial physiology- Molecular epidemiology- Non-tuberculous Mycobacteria- Pathogenesis- Pathology- Vaccine development. This Journal does not accept case-reports. The resurgence of interest in tuberculosis has accelerated the pace of relevant research and Tuberculosis has grown with it, as the only journal dedicated to experimental biomedical research in tuberculosis.