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Tuberculin skin test versus interferon-gamma release assay in refugee children: A retrospective cohort study

Chris Elliot1,2, Ben Marais3, Phoebe Williams1

  • 1Department of Community Child Health, Sydney Children's Hospitals Network, Sydney, New South Wales, Australia.

Journal of Paediatrics and Child Health
|February 15, 2018
PubMed

Insights

Comparing tuberculin skin test (TST) and Quantiferon Gold In-Tube (QGIT) in refugee children revealed frequent discordant results. QGIT offers greater specificity for latent tuberculosis infection (LTBI) diagnosis in BCG-vaccinated populations.

Area of Science:

  • Infectious Diseases
  • Public Health
  • Pediatrics

Background:

  • Latent tuberculosis infection (LTBI) diagnosis in refugee children presents challenges due to factors like BCG vaccination.
  • Accurate LTBI diagnosis is crucial for timely clinical management and preventing disease progression.

Purpose of the Study:

  • To compare tuberculin skin test (TST) and Quantiferon Gold In-Tube (QGIT) results in refugee children.
  • To evaluate the utility of these tests in guiding clinical management and follow-up for LTBI in this population.

Main Methods:

  • Retrospective analysis of refugee children (<15 years) evaluated for LTBI using both TST and interferon-gamma release assay (QGIT).
  • Data collected included demographics, BCG vaccination status, chest X-ray, test results, clinical management, and long-term follow-up.

Main Results:

  • High percentage of discordant TST and QGIT results observed in 212 evaluated refugee children.
  • Among TST-positive children, many were QGIT-negative, particularly those with BCG scars or younger than 2 years.
  • Among QGIT-positive children, many were TST-negative, with a high prevalence of BCG scars.

Conclusions:

  • Discordant results between TST and QGIT are common in refugee children.
  • Quantiferon Gold In-Tube (QGIT) is more specific than TST for diagnosing LTBI in BCG-vaccinated children.
  • Clinical assessment and tuberculosis exposure history remain vital for accurate LTBI diagnosis and management.
Abstract

Keywords:
childhealth screeninglatent tuberculosisrefugee healthtuberculosis/diagnosis

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