Detection of M. tuberculosis in clinical specimens of children has a low sensitivity because
specimens are either difficult to collect or contain low levels of M. tuberculosis.
Diagnostic criteria are non-specific and culture confirmation is challenging, as sputum
samples are not often obtainable from small children and specimens typically have low yield.
Although children are typically thought to have paucibacillary disease, they are at greater
risk for dissemination of TB. This may allow for detection of Mycobacterium tuberculosis from
other bodily fluids than sputum or gastric aspirate, including blood and urine.
Unfortunately, little is known about the overall yield from these various specimens. From
pilot data collected among adults and children in Tugela Ferry, we know that it is feasible
to collect and test various bodily fluid specimens for TB culture. This study aim to test the
hypothesis that blood and urine cultures will detect Mycobacterium tuberculosis from children
suspected of disseminated TB, and that a proportion of these non-sputum bodily fluids will
detect both drug-susceptible and drug-resistant tuberculosis when sputum or gastric culture