Pediatric Infectious Disease Journal
Volume 34, Issue 1, 2015, Pages 35-39

Evaluation of QuantiFERON-TB gold in-tube and tuberculin skin tests among immigrant children being screened for latent tuberculosis infection (Article)

Howley M.M.* , Painter J.A. , Katz D.J. , Graviss E.A. , Reves R. , Beavers S.F. , Garrett D.O.
  • a Centers for Disease Control and Prevention, Mailstop F-61, 1600 Clifton Road N.E., Atlanta, GA 30333, United States
  • b Centers for Disease Control and Prevention, Mailstop F-61, 1600 Clifton Road N.E., Atlanta, GA 30333, United States
  • c Centers for Disease Control and Prevention, Mailstop F-61, 1600 Clifton Road N.E., Atlanta, GA 30333, United States
  • d Methodist Hospital Research Institute, Houston, TX, United States
  • e Denver Health and Hospital Authority, Denver, CO, United States
  • f Centers for Disease Control and Prevention, Mailstop F-61, 1600 Clifton Road N.E., Atlanta, GA 30333, United States
  • g Centers for Disease Control and Prevention, Mailstop F-61, 1600 Clifton Road N.E., Atlanta, GA 30333, United States

Abstract

Background: Centers for Disease Control and Prevention requirements for pre-immigration tuberculosis (TB) screening of children 2- to 14-years old permit a tuberculin skin test (TST) or an interferon-gamma release assay (IGRA). Few data are available on the performance of IGRAs versus TSTs in foreign-born children. Methods: We compared the performance of TST and QuantiFERON-TB (QFT) Gold In-Tube in children 2- to 14-years old applying to immigrate to the United States from Mexico, the Philippines and Vietnam, using diagnosis of TB in immigrating family members as a measure of potential exposure. Results: We enrolled 2520 children: 664 (26%) were TST+ and 142 (5.6%) were QFT+. One hundred and eleven (4.4%) were TST+/QFT+, 553 (21.9%) were TST+/QFT. and 31 (1.2%) were TST-/QFT+. Agreement between tests was poor (κ = 0.20). Although positive results of both tests were significantly associated with older age (relative risks [RR] TST+, 1.64; 95% confidence interval [CI]: 1.36-1.97; RR QFT+, 3.05; 95% CI: 1.72-5.38) and with the presence of TB in at least 1 immigrating family member (RR TST+, 1.40; 95% CI: 1.12-1.75; RR QFT+ 2.24; 95% CI: 1.18-4.28), QFT+ results were more strongly associated with both predictive variables. Conclusions: The findings support the preferential use of QFT over TST for pre-immigration screening of foreign-born children 2 years of age and older and lend support to the preferential use of IGRAs in testing foreign-born children for latent TB infection. Copyright © 2014 by Lippincott Williams & Wilkins.

Author Keywords

interferon-gamma release assay tuberculosis Tuberculin skin test Foreign birth Latent tuberculosis infection

Index Keywords

prospective study immigrant Mycobacterium tuberculosis test kit task performance mass screening Prospective Studies human Skin Tests interferon gamma release assay Interferon-gamma Release Tests priority journal screening test Mexico intermethod comparison procedures United States Humans migrant latent tuberculosis infection Adolescent skin test male latent tuberculosis preschool child clinical evaluation Viet Nam risk factor Emigrants and Immigrants Child, Preschool female Article major clinical study tuberculin test Philippines Child
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-84926178050&doi=10.1097%2fINF.0000000000000494&partnerID=40&md5=e533a2f4a59137001d4ea17f2f9f7e03
DOI: 10.1097/INF.0000000000000494
ISSN: 08913668
Cited by: 29
Original Language: English