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Related Experiment Videos

Risk for tuberculosis among children.

Hiroshi Nakaoka1, Lovett Lawson, S Bertel Squire

  • 1Liverpool School of Tropical Medicine, Liverpool, United Kingdom.

Emerging Infectious Diseases
|November 1, 2006
PubMed
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The QuantiFERON Gold in Tube (QFT-IT) test may be more sensitive than the tuberculin skin test (TST) for detecting tuberculosis infection in children. TST may underestimate infection risk in child contacts of TB patients.

Area of Science:

  • Infectious Diseases
  • Pediatric Health
  • Diagnostic Immunology

Background:

  • Tuberculosis (TB) remains a significant global health concern, particularly for children exposed to infected adults.
  • Accurate identification of TB infection in child contacts is crucial for timely intervention and disease prevention.
  • Traditional diagnostic methods like the tuberculin skin test (TST) have limitations in sensitivity and specificity.

Purpose of the Study:

  • To compare the performance of an interferon-gamma (IFN-γ) release assay, the QuantiFERON Gold in Tube (QFT-IT) test, against the TST in assessing TB infection risk among children.
  • To evaluate the diagnostic accuracy of QFT-IT and TST in different contact scenarios with TB-positive and TB-negative adults.

Main Methods:

  • A study involving 207 children in Nigeria was conducted, categorizing them into three groups: close contacts of adults with smear-positive TB, contacts of adults with smear-negative TB, and healthy controls.

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  • Both the TST and the QFT-IT assay were administered to assess the prevalence of latent TB infection within these groups.
  • Statistical analysis was performed to compare the results obtained from both diagnostic tests across the study groups.

    • Main Results:

    • The QFT-IT test showed significantly higher positivity rates compared to the TST across all groups (p < 0.01).
    • Specifically, QFT-IT identified a higher proportion of infected children among contacts of both smear-positive and smear-negative TB cases.
    • Discrepancies were noted, with QFT-IT often positive when TST was negative, particularly in contacts of TB-positive individuals.

    Conclusions:

    • The QFT-IT test appears to be more sensitive than the TST in detecting Mycobacterium tuberculosis infection in children, especially in high-risk contact settings.
    • The TST may underestimate the true risk of TB infection in children exposed to adults with tuberculosis.
    • QFT-IT offers a potentially more reliable diagnostic tool for evaluating TB infection risk in pediatric populations.