Updates from Stool4DR-TB: A Project on Stool-based testing for TB diagnosis in Tanzania

By 2025, we have come a long way with stool-based testing to diagnose tuberculosis (TB). As of today, we have demonstrated that more children and people living with HIV can be timely diagnosed with TB by using stool-based testing. But there are still challenges to this method that our Diagnostics team at KNCV Tuberculosis Foundation is looking into. In this article we share the updates from Stool4DR-TB: a project on stool-based testing for TB diagnosis in Tanzania.

Challenges of Stool-based testing

The SOS Stool-Based Testing for TB diagnosis is part of the KNCV efforts to strengthening a holistic approach to addressing TB in children and adolescents. Our current work around this diagnostic method aims to address the following challenges:

  • Firstly, not every stool sample reaches the laboratory in optimal time and condition; and
  • secondly, it is not yet clear whether resistance to anti-TB drugs other than Rifampicin can be determined reliably with stool-based testing.

To address these issues, our Diagnostics team is testing if transporting stool in a novel molecular transport medium provides better test results than transporting stool in a conventional container without this medium. This study is funded by Bakhuys Roozeboom Stichting and is being conducted in Tanzania with the support of the National Institute for Medical Research (NIMR) and the Central TB and Leprosy Reference Laboratory (CTRL) in Tanzania.

About Stool-based testing in Tanzania

In the Stool4DR-TB project, a small portion of the stool collected is transferred into the novel molecular transport medium and sent together with the original stool through the routine transport system from the healthcare centers to a central laboratory. Upon arrival in the laboratory both samples are tested for TB and anti-TB drugs using the GeneXpert technology.

In the first weeks of January, we enrolled the first nine participants in this study. We anticipate that by mid-2025 we will have included enough people with TB in the study to conclude on the study results and how this contributes to improving TB diagnosis using stool-based testing.

Stay tuned and follow our updates!

Together we can end TB!

KNCV has been fighting TB since its establishment in 1903. Over the past 120 years, the organization has acquired indispensable knowledge and experience in the field of effective TB prevention and care, resulting in pre-elimination in the Netherlands and significant contributions to global evidence generation, policy development and TB program implementation worldwide.

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