PMID- 20068506
OWN - NLM
STAT- MEDLINE
DCOM- 20100809
LR  - 20211028
IS  - 1532-0987 (Electronic)
IS  - 0891-3668 (Linking)
VI  - 29
IP  - 5
DP  - 2010 May
TI  - Commercial interferon gamma release assays compared to the tuberculin skin test 
      for diagnosis of latent Mycobacterium tuberculosis infection in childhood 
      contacts in the Gambia.
PG  - 439-43
LID - 10.1097/INF.0b013e3181cb45da [doi]
AB  - BACKGROUND: We compared the performance of tuberculin skin test (TST), 
      Quantiferon-TB Gold in-tube (QFT-GIT), and T-SPOT.TB in diagnosing latent 
      tuberculosis (LTBI) among childhood TB contacts in a TB endemic setting with high 
      BCG coverage. We evaluated the performance of interferon gamma release assays 
      (IGRAs) and TST when combined in an algorithm. METHODS: Childhood contacts of 
      newly diagnosed TB patients were tested with TST, QFT-GIT, and T-SPOT. The level 
      of exposure in contacts was categorized according to whether they slept in the 
      same room, same house, or a different house as the index case. For the evaluation 
      of combined test performance, prior estimates for prevalence of latent TB were 
      used in Bayesian models that assumed conditional dependence between tests. 
      RESULTS: A total of 285 children were recruited. Overall, 26.5%, 33.0%, and 33.5% 
      were positive for TST, T-SPOT, or QFT-GIT, respectively. All 3 tests responded to 
      the gradient of sleeping proximity to the index case. Neither TST nor IGRA 
      results were confounded by BCG vaccination. There was moderate agreement (kappa = 
      0.40-0.68) between all 3 tests. Combination of either IGRA with TST increased 
      sensitivity (by 9.3%-9.6%) especially in contacts in the highest exposure 
      category but was associated with loss of specificity (9.9%-11.3%). CONCLUSION: 
      IGRAs and TST are similar in their diagnostic performance for LTBI. An 
      approximate 10% sensitivity benefit for using the TST and an IGRA in combination 
      is associated with a slightly greater specificity loss. Testing strategies 
      combining an IGRA and TST with an "or" statement may be useful only in situations 
      where there is a high pretest probability of latent infection.
FAU - Adetifa, Ifedayo M O
AU  - Adetifa IM
AD  - Bacterial Diseases Program, Medical Research Council (UK) Laboratories, Fajara, 
      Banjul, The Gambia. iadetifa@mrc.gm
FAU - Ota, Martin O C
AU  - Ota MO
FAU - Jeffries, David J
AU  - Jeffries DJ
FAU - Hammond, Abdulrahman
AU  - Hammond A
FAU - Lugos, Moses D
AU  - Lugos MD
FAU - Donkor, Simon
AU  - Donkor S
FAU - Patrick, Owiafe
AU  - Patrick O
FAU - Adegbola, Richard A
AU  - Adegbola RA
FAU - Hill, Philip C
AU  - Hill PC
LA  - eng
GR  - MC_U190071468/MRC_/Medical Research Council/United Kingdom
GR  - MC_U190081968/MRC_/Medical Research Council/United Kingdom
PT  - Comparative Study
PT  - Evaluation Study
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - Pediatr Infect Dis J
JT  - The Pediatric infectious disease journal
JID - 8701858
RN  - 0 (BCG Vaccine)
RN  - 0 (Tuberculin)
RN  - 82115-62-6 (Interferon-gamma)
SB  - IM
MH  - Adolescent
MH  - BCG Vaccine/immunology
MH  - Child
MH  - Child, Preschool
MH  - Endemic Diseases
MH  - Female
MH  - Gambia/epidemiology
MH  - Humans
MH  - Immunologic Tests/*methods
MH  - Infant
MH  - Interferon-gamma/immunology
MH  - Latent Tuberculosis/*diagnosis/*epidemiology
MH  - Male
MH  - Sensitivity and Specificity
MH  - Tuberculin/immunology
MH  - Vaccination/statistics & numerical data
EDAT- 2010/01/14 06:00
MHDA- 2010/08/10 06:00
CRDT- 2010/01/14 06:00
PHST- 2010/01/14 06:00 [entrez]
PHST- 2010/01/14 06:00 [pubmed]
PHST- 2010/08/10 06:00 [medline]
AID - 10.1097/INF.0b013e3181cb45da [doi]
PST - ppublish
SO  - Pediatr Infect Dis J. 2010 May;29(5):439-43. doi: 10.1097/INF.0b013e3181cb45da.