QuantiFERON®-TB Gold In-Tube Performance for Diagnosing Active Tuberculosis in Children and Adults in a High Burden Setting

Rose, Mandy; Kimaro, Godfather; Nissen, Thomas Nørrelykke; Kroidl, Inge; Höelscher, Michael; Bygbjerg, Ib Christian; Mfinanga, Sayoki; Ravn, Pernille

doi:10.1371/journal.pone.0037851

Cited by 43 publications

(56 citation statements)

References 23 publications

(31 reference statements)

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“…Higuchi et al also observed a low performance of the TST in discriminating between close and casual contacts in BCG-vaccinated primary school students from Japan, a low burden country [19]. In contrast, the results from studies investigating risk factors for TST positivity in The Gambia, Brazil, and Tanzania, all high burden countries, are similar to our findings [20][21][22]. These studies also concluded that the TST remains a useful test for the identification of children infected with M. tuberculosis, independent of BCG vaccination status.…”

Section: Discussionsupporting

confidence: 88%

Influence of Bacille Calmette-Guérin on tuberculin skin testing in Venezuelan Amerindians in high tuberculosis burden areas

Maes

Verhagen

Ortega³

et al. 2014

J Infect Dev Ctries

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Introduction: Extraordinarily high tuberculosis (TB) prevalence rates have been reported in Venezuelan Amerindians. Amerindian populations often live in geographically isolated villages where they receive little medical attention and live under precarious sanitary conditions. TB prevalence varies by ethnicity and geographic location and is generally higher in Amerindians than in non-indigenous (Creole) people. Methodology: Between January 1, 1998 and December 31, 2009, the tuberculin skin test (TST) was administered during field operations to 9,538 Amerindian and Creole people between 0 and 94 years of age living in Venezuela. In 6,979 individuals (73%), Bacille CalmetteGuérin (BCG) vaccination status, age, and ethnicity were recorded.Univariate and multivariate analyses were performed to determine the influence of previous BCG vaccination, age, and ethnicity on TST outcomes. Results: Age, ethnicity, and the number of BCG vaccinations administered each had a significant influence on TST outcomes (p < 0.001). The influence of BCG vaccination on TST outcomes varied by ethnicity and was only significant in children aged between 0 and 3 years. Conclusions: The utility of TST in the diagnosis of TB infection in high TB burden settings with widespread BCG vaccination should be evaluated locally and individually as this depends on ethnicity, age, and the number of BCG vaccinations administered. In Venezuelan children 4 years of age and older, the TST remains a useful tool for the detection of TB infection, independent of BCG vaccination status.

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Section: Discussionsupporting

confidence: 88%

Influence of Bacille Calmette-Guérin on tuberculin skin testing in Venezuelan Amerindians in high tuberculosis burden areas

Maes

Verhagen

Ortega³

et al. 2014

J Infect Dev Ctries

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“…The meta-analytic estimate for specificity was not performed since only data from 2 studies were available [34,43]. Meta-analytic estimate for sensitivity and specificity for T-SPOT.TB was not performed due to lack of data.…”

Section: Sub-analysis In Immunocompromised/hiv-infected Children Popumentioning

confidence: 99%

Systematic review and meta-analysis on the utility of Interferon-gamma release assays for the diagnosis of Mycobacterium tuberculosis finfection in children: a 2013 update

et al. 2014

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BackgroundPrevious meta-analyses regarding the performance of interferon-gamma release assays (IGRAs) for tuberculosis diagnosis in children yielded contrasting results, probably due to different inclusion/exclusion criteria.MethodsWe systematically searched PubMed, EMBASE and Cochrane databases and calculated pooled estimates of sensitivities and specificities of QuantiFERON-TB Gold In Tube (QFT-G-IT), T-SPOT.TB, and tuberculin skin test (TST). Several sub-analysis were performed: stratification by background (low income vs. high income countries); including only microbiological confirmed TB cases; including only studies performing a simultaneous three-way comparison of the three tests, and including immunocompromised children.ResultsOverall, 31 studies (6183 children) for QFT-G-IT, 14 studies (2518 children) for T-SPOT.TB and 34 studies (6439 children) for TST were included in the analyses. In high income countries QFT-G-IT sensitivity was 0.79 (95%IC: 0.75-0.82) considering all the studies, 0.78 (95%CI:0.70-0.84) including only studies performing a simultaneous three-way comparison and 0.86 (95%IC 0.81-0.90) considering only microbiologically confirmed studies. In the same analyses T-SPOT.TB sensitivity was 0.67 (95%IC 0.62-0.73); 0.76 (95%CI: 0.68 to 0.83); and 0.79 (95%IC 0.69-0.87), respectively. In low income countries QFT-G-IT pooled sensitivity was significantly lower: 0.57 (95%IC:0.52-0.61), considering all the studies, and 0.66 (95%IC 0.55-0.76) considering only microbiologically confirmed cases; while T-SPOT.TB sensitivity was 0.61 (95%IC 0.57-0.65) overall, but reached 0.80 (95%IC 0.73-0.86) in microbiologically confirmed cases. In microbiologically confirmed cases TST sensitivity was similar: 0.86 (95%IC 0.79-0.91) in high income countries, and 0.74 (95%IC 0.68-0.80) in low income countries. Higher IGRAs specificity with respect to TST was observed in high income countries (97-98% vs. 92%) but not in low income countries (85-93% vs. 90%).ConclusionsBoth IGRAs showed no better performance than TST in low income countries.

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“…Malnutrition can also cause indeterminate QuantiFERON test results. 2 It is notable that most of the data on malnutrition and immunologic tests for TB come from international settings [2][3][4] where the definitions of malnutrition vary from those in the United States. As the QuantiFERON test and the tuberculin skin test are tests of immune recognition, it is not surprising that both would be affected by the immunosuppressive state caused by malnutrition.…”

Section: Dr Cruzmentioning

confidence: 99%

A Case of an 11-year-old With Cough, Diarrhea, and Findings of Concern in His Lungs and Spleen

Darby¹,

Rees²,

Bocchini³

et al. 2016

Pediatrics

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This is the case of a previously healthy, 11-year-old male of Indian descent who presented to the emergency department with a 2-month history of nausea, vomiting, diarrhea, fatigue, cough, and 7-lb weight loss. Acutely, he developed 5 days of fever as high as 39.4°C. He had a remote travel history to the Middle East. On physical examination, he was febrile and tachycardic, was thin but otherwise had a normal examination. His inflammatory markers were elevated: erythrocyte sedimentation rate was 93 mm/hour and his C-reactive protein was 25.4 mg/L. A complete blood count revealed a white blood cell count of 17 000 × 10 3 /μL with increased bands. His hemoglobin level was 8.8 g/dL with a mean corpuscular volume of 81 fl. Platelets were 556 × 10 3 /μL. A chest radiograph was concerning for a cavitary lung lesion and an abdominal ultrasound revealed multiple hypoechoic lesions in his spleen. Our panel of experts reviews his case and examines the workup of this patient with diverse symptoms and focal findings on chest radiograph and abdominal ultrasound. abstract Departments of a Pediatrics and b Pathology, Baylor College of Medicine/Texas Children's Hospital, Houston, TexasDr Darby contributed to the design and execution of the case conference, drafted and edited the original manuscript, and made revisions to the manuscript; Drs Rees, Barlow, Kellermayer, Bocchini, Cruz, and Finegold contributed to the design and execution of the case conference and reviewed and made revisions to the manuscript; and all authors approved the fi nal manuscript as submitted.

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QuantiFERON®-TB Gold In-Tube Performance for Diagnosing Active Tuberculosis in Children and Adults in a High Burden Setting

Cited by 43 publications

References 23 publications

Influence of Bacille Calmette-Guérin on tuberculin skin testing in Venezuelan Amerindians in high tuberculosis burden areas

Influence of Bacille Calmette-Guérin on tuberculin skin testing in Venezuelan Amerindians in high tuberculosis burden areas

Systematic review and meta-analysis on the utility of Interferon-gamma release assays for the diagnosis of Mycobacterium tuberculosis finfection in children: a 2013 update

A Case of an 11-year-old With Cough, Diarrhea, and Findings of Concern in His Lungs and Spleen

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