在越南的家庭接触者中进行结核素皮肤检测和QuantiFERONTM-TB Gold Plus阳性检测
A L Innes1, S T Nguyen2, V Lebrun3
1FHI 360 Asia Pacific Regional Office, Bangkok, Thailand.
Public health action
|September 22, 2023
概括
结核素皮肤试验 (TST) 对结核病感染诊断的阳性根据试剂和解释值 (≥5毫米对≥10毫米) 有显著差异. 常规的TST实施需要在高TB负担设置中仔细监测诊断测试可靠性.
科学领域:
- 结核病诊断方法 结核病诊断方法
- 传染病流行病学 传染病流行病学
- 公共卫生干预措施 公共卫生干预措施
背景情况:
- 结核素皮肤测试 (TST) 和干扰素释测试 (IGR) 用于结核病感染的诊断.
- 之前的研究表明,越南家庭接触者的TST值为10毫米.
- 使用不同的试剂进行常规的测试试验,结果呈现出意想不到的低阳性率.
研究的目的:
- 为了比较TST结果 (5毫米和10毫米值) 与QuantiFERONTM-TB Gold Plus (QFT) 在家庭接触中.
- 在现实世界的实施环境中评估TST阳性率和与QFT的协议.
- 评估影响TST和QFT阳性的因素.
主要方法:
- 进行了一项跨部门,多中心的实施研究.
- 在2020年对1,330个家庭接触者和2021年对1,158个家庭接触者进行了TST (5毫米和10毫米) 和QFT.
- 统计分析包括麦克纳马的测试来评估不一致.
主要成果:
- 根据QFT,TBI患病率为38.6%,类似于TST5毫米 (37.4%),但高于TST10毫米 (13.1%).
- QFT和TST 5毫米之间的协议并不矛盾 (P = 0.5),而QFT与TST 10毫米 (P < 0.01) 不一致.
- 年龄较大和南部地区与阳性TST5mm和QFT相关.
结论:
- 结核素试剂显著影响TST阳性率.
- 高结核病负担的国家必须监测TBI诊断可靠性,包括试剂效力和检测技术.
- 优化结核病预防治疗资格需要可靠的诊断方法.
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