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Accuracy of QuantiFERON-TB Gold Test for Tuberculosis Diagnosis in Children
Michela Sali1, Danilo Buonsenso2, Delia Goletti3
1Institute of Microbiology, Università Cattolica del Sacro Cuore, Rome, Italy.
Insights
The QuantiFERON-TB Gold assay (QFT-IT) shows high accuracy in diagnosing active tuberculosis (TB) and latent TB infection (LTBI) in children. Its effectiveness extends to very young children, supporting its use in pediatric TB diagnostics.
Area of Science:
- Pediatric infectious diseases
- Immunodiagnostics
- Tuberculosis research
Background:
- Tuberculosis (TB) remains a significant global health concern, particularly in pediatric populations.
- Accurate diagnostic tools are crucial for timely management of TB infection in children.
- The QuantiFERON-TB Gold assay (QFT-IT) is an Interferon-Gamma Release Assay (IGRA) used for TB diagnosis.
Purpose of the Study:
- To assess the diagnostic accuracy of the QuantiFERON-TB Gold assay (QFT-IT) in children suspected of having active or latent TB infection (LTBI).
- To evaluate the QFT-IT's performance across different age groups within the pediatric population.
Main Methods:
- A retrospective study involving 621 children aged 0-14 years evaluated for TB infection or disease.
- Children underwent clinical assessment followed by testing with the QFT-IT assay.
- Analysis of QFT-IT results in relation to confirmed active TB cases and LTBI risk factors.
Main Results:
- The QFT-IT demonstrated an overall sensitivity of 87.5% and specificity of 93.6% for active TB in children.
- Sensitivity varied by age, from 62.5% in 25-36 month olds to 100% in children over 49 months.
- In LTBI screening, 38 out of 481 children tested positive, with most having identifiable risk factors.
Conclusions:
- QFT-IT results correlate with active TB and risk factors for LTBI in children.
- The assay shows reliable mitogen response even in children as young as one year old.
- These findings support the use of QFT-IT for TB diagnosis in young children.
Objectives:
To evaluate the accuracy of the QuantiFERON-TB Gold assay (QFT-IT) in children with suspected active or latent TB infection (LTBI).
Methods:
A retrospective study was conducted on 621 children (0-14 years old) evaluated for TB infection or disease. Following clinical assessment, children were tested with the QFT-IT assay.
Results:
Among the 140 active TB suspects, we identified 19 cases of active disease. The overall sensitivity for active TB was 87.5%, ranging from 62.5% in children 25-36 months old to 100% in children older than 49 months. The overall specificity for active TB was 93.6%. Among the 481 children tested for LTBI screening, 38 scored positive and all but 2 had at least one risk factor for TB infection. Among the 26 children with indeterminate results, bacterial, viral or fungal pneumonia were later diagnosed in 11 (42.3%) cases and non-TB related extra-pulmonary infections in 12 (46.1%).
Conclusions:
Our results indicate that the children's response to QFT-IT associates to active TB and risk factors for LTBI. Moreover, we show that mitogen response is also found in children of 1 year of age, providing support for QFT-IT use also in young children.
