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Effective Tuberculosis Contact Investigation Using Interferon-Gamma Release Assays

Rutger Bennet1, Sahar Nejat, Margareta Eriksson

  • 1From the Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden.

The Pediatric Infectious Disease Journal
|March 19, 2019
PubMed

Insights

Tuberculosis screening in children exposed to TB found a 33% positive tuberculin skin test rate and a 12% positive interferon-gamma release assay rate. Children with positive tests had a 6.1% to 13% risk of developing active tuberculosis disease.

Area of Science:

  • Pediatric infectious diseases
  • Public health surveillance
  • Mycobacterial infections

Background:

  • Tuberculosis (TB) remains a significant global health concern, particularly in pediatric populations.
  • Contact investigation is crucial for early detection and prevention of TB transmission.
  • Assessing the diagnostic yield of different TB screening methods in children is essential for effective public health strategies.

Purpose of the Study:

  • To evaluate the effectiveness of tuberculin skin test (TST) and interferon-gamma release assay (IGRA) in identifying children with latent or active tuberculosis infection.
  • To determine the risk of developing active tuberculosis disease among children who tested positive for TB infection using TST or IGRA.
  • To analyze screening data from a defined pediatric cohort undergoing TB contact investigation.

Main Methods:

  • Retrospective analysis of TB screening data from 1831 children screened between 2000 and 2018.
  • Utilized tuberculin skin test (TST) and interferon-gamma release assay (IGRA) for TB infection detection.
  • Calculated the incidence of positive test results and the subsequent risk of active tuberculosis disease.

Main Results:

  • A total of 1831 children were screened; 33% had a positive TST and 12% had a positive IGRA.
  • Among children with positive TST results, 6.1% developed active tuberculosis disease.
  • Among children with positive IGRA results, 13% developed active tuberculosis disease.

Conclusions:

  • Both TST and IGRA are valuable tools for TB screening in children during contact investigations.
  • IGRA may indicate a higher risk of progression to active TB disease compared to TST in this pediatric cohort.
  • Continued vigilance and follow-up are necessary for children with positive TB tests to prevent disease progression.

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