Sputum collection

Clinical description

• TB in children is usually sputum smear-negative since they often have very little MTB

in their lungs

• Sputum in younger children with TB contains few TB bacilli, but this is not true for

older children (> 8 years of age).

• The sputum smear (and sputum for GeneXpert MTB/RIF or TB culture, where available)

remains a valuable test to perform in any child who can produce a sputum specimen.

• In children who are unable to expectorate spontaneously, obtaining an aspirate of

gastric fluid is a reasonable approach to diagnosis.

• Gastric aspirates can be safely performed in hospitals after a 3-hour fast or early in the

morning after an overnight fast.