Tuberculosis diagnosis in children with modified FFP2 mask

Around 10.6 million people worldwide contracted tuberculosis in 2022, including 1.3 million children. Diagnosis in adults is usually based on the detection of Mycobacterium tuberculosis DNA in sputum. This is more difficult in children, however, as they rarely produce sputum. It is estimated that around 60 percent of tuberculosis cases in children are not diagnosed, which has serious consequences. One in five children under the age of 14 will die from tuberculosis if they are not treated.

FFP2 masks, which filter exhaled air, have already been successfully used to detect tuberculosis bacteria in adults.However, a corresponding study for children has not yet been conducted. Lennard Meiwes, a medical student from Lübeck, developed a method at the Borstel Research Center to detect M. tuberculosis DNA from children's respiratory masks. Together with doctors in Germany and the Republic of Moldova, he conducted a clinical study to demonstrate its feasibility.

In the study, children with pulmonary tuberculosis wore three modified FFP2 masks for half an hour at a time.These masks contained a strip of 3D-printed polyvinyl alcohol that collects samples from the breath.The masks were then analyzed using manual and automated polymerase chain reaction (qPCR) and targeted molecular biology methods.

Lennard Meiwes was able to make the method so sensitive that the detection limit was reduced to less than 4 copies of the pathogen's genetic material. Despite these promising results in the laboratory, M. tuberculosis DNA could not be detected in any of 30 masks worn by children for 30 minutes each.

"Although our method showed such a low detection limit, we were unable to detect the genetic material of the tuberculosis bacteria in clinical use in children. These results indicate that children with pulmonary tuberculosis probably do not form aerosols through which the bacteria are transmitted," explains Meiwes. This work was published in the Journal of Infectious Diseases.

Dariusz Wölk, a medical student from the University of Hamburg, is now examining the results in adults in the Republic of Moldova.His project is also funded by the German Center for Infection Research (DZIF). Initial results show that the method works in adults.The study shows that children with pulmonary tuberculosis are unlikely to produce infectious aerosols.This has important implications for the diagnosis and treatment of TB in children and could lead to new, less invasive diagnostic methods. Research will continue to confirm the results in adults and refine the method.

MEDICA-tradefair.com; Source: Research Center Borstel, Leibniz Lung Center