Evaluation of QuantiFERON-TB Gold In-Tube and Tuberculin Skin Tests Among Immigrant Children Being Screened for Latent Tuberculosis Infection

Details

• Alternative Title:
  Pediatr Infect Dis J
• Personal Author:
  Howley, Meredith M. ; Painter, John A. ; Katz, Dolores J. ; Graviss, Edward A. ; Reves, Randall ; Beavers, Suzanne F. ; Garrett, Denise O.
• Description:
  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.
• Keywords:
  • tuberculosis
  • latent tuberculosis infection
  • interferon-gamma release assay
  • tuberculin skin test
  • foreign birth
  • Adolescent
  • Child
  • Child, Preschool
  • Emigrants and Immigrants
  • Female
  More +
• Source:
  Pediatr Infect Dis J. 34(1):35-39
• Pubmed ID:
  25093974
• Pubmed Central ID:
  PMC5136477
• Document Type:
  Journal Article
• Funding:
  CC999999/Intramural CDC HHSUnited States/
• Volume:
  34
• Issue:
  1
• Download URL:
  https://stacks.cdc.gov/view/cdc/43116/cdc_43116_DS1.pdf
• File Type:
  [PDF - 472.73 KB]
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:9982fdca72da9ebf8edf25b98bd498ed8b29736b48d3661f120458fea6608cff