Tuberculosis progression rates in U.S. Immigrants following screening with interferon-gamma release assays

Blount, Robert J.; Tran, Minh Chi; Everett, Charles K.; Cattamanchi, Adithya; Metcalfe, John; Connor, Denise M.; Miller, Cecily; Grinsdale, Jennifer; Higashi, Julie; Nahid, Payam

doi:10.1186/s12889-016-3519-6

Cited by 12 publications

(15 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The search of PubMed generated 2399 results ( Figure 1), of which 59 7,9,10, included the required information on PPV and/or NPV (see Appendix 2, Figure 14). In addition, we are aware of a further relevant study 78 that was published after we conducted our review. Many of these 59 studies did not have the primary aim of assessing diagnostic accuracy.…”

Section: Diagnostic Performance Of Interferon Gamma Release Assays Fomentioning

confidence: 99%

“…Many of these 59 studies did not have the primary aim of assessing diagnostic accuracy. Many recorded few cases of active TB (often < 10) 22,[25][26][27][29][30][31][32][33][35][36][37][38]40,[42][43][44][45]47,48,50,51,[56][57][58][59][62][63][64][65][67][68][69][70][71][72][73][74][75]77,78 and/or were restricted to groups such as patients infected with HIV, 9,28,29,36,49,51,56,60,65,…”

Section: Diagnostic Performance Of Interferon Gamma Release Assays Fomentioning

confidence: 99%

“…Consistent with the previous systematic review, 15 estimates of PPV were consistently low, ranging from 0% to 24%; NPV was considerably higher (always ≥ 90%). Eighteen studies (including the additional study 78 ) did specifically assess the diagnostic accuracy of IGRAs for future development of active TB (Table 1) or otherwise quantify the association between a positive IGRA and subsequent TB. Of these, five assessed both IGRAs and TST.…”

Section: Diagnostic Performance Of Interferon Gamma Release Assays Fomentioning

confidence: 99%

“…2)78 and 7.7 (95% CI 2.8 to 21.2) 52. Doyle et al29 estimated the hazard ratio as 42.4 (95% CI 2.2 to 827) after adjustment for age, gender, cluster of differentiation 4 (CD4) count, viral load and country of birth.…”

mentioning

confidence: 99%

See 3 more Smart Citations

Two interferon gamma release assays for predicting active tuberculosis: the UK PREDICT TB prognostic test study

Abubakar

Lalvani

Southern

et al. 2018

Health Technol Assess

View full text Add to dashboard Cite

Background Despite a recent decline in the annual incidence of tuberculosis (TB) in the UK, rates remain higher than in most Western European countries. The detection and treatment of latent TB infection (LTBI) is an essential component of the UK TB control programme. Objectives To assess the prognostic value and cost-effectiveness of the current two interferon gamma release assays (IGRAs) compared with the standard tuberculin skin test (TST) for predicting active TB among untreated individuals at increased risk of TB: (1) contacts of active TB cases and (2) new entrants to the UK from high-TB-burden countries. Design A prospective cohort study and economic analysis. Participants and setting Participants were recruited in TB clinics, general practices and community settings. Contacts of active TB cases and migrants who were born in high-TB-burden countries arriving in the UK were eligible to take part if they were aged ≥ 16 years. Main outcome measures Outcomes include incidence rate ratios comparing the incidence of active TB in those participants with a positive test result and those with a negative test result for each assay, and combination of tests and the cost per quality-adjusted life-year (QALY) for each screening strategy. Results A total of 10,045 participants were recruited between May 2010 and July 2015. Among 9610 evaluable participants, 97 (1.0%) developed active TB. For the primary analysis, all test data were available for 6380 participants, with 77 participants developing active TB. A positive result for TSTa (positive if induration is ≥ 5 mm) was a significantly poorer predictor of progression to active TB than a positive result for any of the other tests. Compared with TSTb [positive if induration is ≥ 6 mm without prior bacillus Calmette–Guérin (BCG) alone, T-SPOT®.TB (Oxford Immunotec Ltd, Oxford, UK), TSTa + T-SPOT.TB, TSTa + IGRA and the three combination strategies including TSTb were significantly superior predictors of progression. Compared with the T-SPOT.TB test alone, TSTa + T-SPOT.TB, TSTb + QuantiFERON® TB Gold In-Tube (QFT-GIT; QIAGEN GmbH, Hilden, Germany) and TSTb + IGRA were significantly superior predictors of progression and, compared with QFT-GIT alone, T-SPOT.TB, TSTa + T-SPOT.TB, TSTa + QFT-GIT, TSTa + IGRA, TSTb + T-SPOT.TB, TSTb + QFT-GIT and TSTb + IGRA were significantly superior predictors of progression. When evaluating the negative predictive performance of tests and strategies, negative results for TSTa + QFT-GIT were significantly poorer predictors of non-progression than negative results for TSTa, T-SPOT.TB and TSTa + IGRA. The most cost-effective LTBI testing strategies are the dual-testing strategies. The cost and QALY differences between the LTBI testing strategies were small; in particular, QFT-GIT, TSTb + T-SPOT.TB and TSTb + QFT-GIT had very similar incremental net benefit estimates. Conclusion This study found modest differences between tests, or combinations of tests, in identifying individuals who would go on to develop active TB. However, a two-step approach that combined TSTb with an IGRA was the most cost-effective testing option. Implications for practice and future research The two-step TSTb strategy, which stratified the TST by prior BCG vaccination followed by an IGRA, was the most cost-effective approach. The limited ability of current tests to predict who will progress limits the clinical utility of tests. The implications of these results for the NHS England/Public Health England national TB screening programme for migrants should be investigated. Study registration This study is registered as NCT01162265. Funding The National Institute for Health Research Health Technology Assessment programme.

show abstract

Section: Diagnostic Performance Of Interferon Gamma Release Assays Fomentioning

confidence: 99%

Section: Diagnostic Performance Of Interferon Gamma Release Assays Fomentioning

confidence: 99%

Section: Diagnostic Performance Of Interferon Gamma Release Assays Fomentioning

confidence: 99%

mentioning

confidence: 99%

See 2 more Smart Citations

Two interferon gamma release assays for predicting active tuberculosis: the UK PREDICT TB prognostic test study

Abubakar

Lalvani

Southern

et al. 2018

Health Technol Assess

View full text Add to dashboard Cite

show abstract

“…Positivity of the IGRA technique predicts the long-term development of TB compared with positive TST [30]. Thus, considering the use of TST and IGRA techniques together, as in the present study, can be a good strategy for deciding to start therapy for LTBI in this risk group [31]. Some limitations should be noted.…”

Section: Discussionmentioning

confidence: 83%

A Pilot Programme for Tuberculosis Screening in Immigrants at Primary Care

Bellmunt-Bardas¹,

Pedro‐Botet²,

Chillarón³

et al. 2019

MEDJ

View full text Add to dashboard Cite

Background: Immigrants from countries with a high prevalence of Tuberculosis (TB) may constitute a source of infection. Objective: The aim of the present study was to describe a Tuberculosis (TB) screening programme at a primary health care centre directed at immigrants from countries with a high prevalence of TB. Methods: This was a descriptive study conducted at a primary health centre in Barcelona between 2009 and 2012 for immigrants from countries with a TB incidence > 100/100,000. They were invited to join the TB detection programme on registering at the primary health care centre when a reference nurse conducted a survey on socio-health data, performed a Tuberculin Skin Test (TST) and requested a chest X-ray. Interferon Gamma Release Assays (IGRA) were applied in individuals with positive TST or an abnormal X-ray. Results: Ninety-one (70.5%) of 129 individuals, aged 29.8 ± 9.8 years, who entered the programme, were men, 60 (46.5%) were from Pakistan and 3 reported previous TB. Eighty-six (66.7%) immigrants completed the study protocol. Three cases (2.3%) of TB were diagnosed and 29 (30.5%) had latent TB infection. Seven chest X-rays yielded other non-TB radiological changes. Conclusion: This TB screening programme should aid early detection of TB and LTBI among immigrants from high-TB prevalence countries on first registering at the primary health care centre.

show abstract

Factors Associated With Sputum Culture-Negative vs Culture-Positive Diagnosis of Pulmonary Tuberculosis

et al. 2019

View full text Add to dashboard Cite

Key Points Question What proportion of patients with pulmonary tuberculosis have negative sputum culture results, and how do they present differently from patients with culture-positive pulmonary tuberculosis? Findings In our cross-sectional study of 796 patients without HIV infection who were diagnosed with pulmonary tuberculosis, sputum culture-negative pulmonary tuberculosis represented 15% of all adult patients with pulmonary tuberculosis in New York, New York. These patients had a significantly lower proportion of cough, weight loss, any symptom in general, and cavitation on imaging compared with patients with sputum culture-positive disease. Meaning Through awareness of these findings, the detection and treatment of this likely early disease could potentially be improved and the development of transmissible tuberculosis reduced.

show abstract

Tuberculosis progression rates in U.S. Immigrants following screening with interferon-gamma release assays

Cited by 12 publications

References 22 publications

Two interferon gamma release assays for predicting active tuberculosis: the UK PREDICT TB prognostic test study

Two interferon gamma release assays for predicting active tuberculosis: the UK PREDICT TB prognostic test study

A Pilot Programme for Tuberculosis Screening in Immigrants at Primary Care

Factors Associated With Sputum Culture-Negative vs Culture-Positive Diagnosis of Pulmonary Tuberculosis

Contact Info

Product

Resources

About