Evaluation of QuantiFERON-TB Gold In-Tube and Tuberculin Skin Tests Among Immigrant Children Being Screened for Latent Tuberculosis Infection. Issue 1 (January 2015)

• Record Type: Journal Article
• Authors: Howley, Meredith M.; Painter, John A.; Katz, Dolores J.; Graviss, Edward A.; Reves, Randall; Beavers, Suzanne F.; Garrett, Denise O.
• Is Part Of: Pediatric infectious disease journal. Volume 34:Issue 1(2015)
• Publication Date: 2015-01
• Subjects: Communicable diseases in children -- Periodicals; Infection in children -- Periodicals; 618.929
• DOI: 10.1097/INF.0000000000000494
• Languages: English
• ISSNs: 0891-3668

Abstract

<abstract> <title> <x xml:space="preserve">Abstract</x> </title> <sec> <title>Background:</title> <p>Centers for Disease Control and Prevention requirements for pre-immigration tuberculosis (TB) screening of children 2- to 14-years old permit a tuberculin skin test (TST) or an interferon-gamma release assay (IGRA). Few data are available on the performance of IGRAs versus TSTs in foreign-born children.</p> </sec> <sec> <title>Methods:</title> <p>We compared the performance of TST and QuantiFERON-TB (QFT) Gold In-Tube in children 2- to 14-years old applying to immigrate to the United States from Mexico, the Philippines and Vietnam, using diagnosis of TB in immigrating family members as a measure of potential exposure.</p> </sec> <sec> <title>Results:</title> <p>We enrolled 2520 children: 664 (26%) were TST+ and 142 (5.6%) were QFT+. One hundred and eleven (4.4%) were TST+/QFT+, 553 (21.9%) were TST+/QFT− and 31 (1.2%) were TST−/QFT+. Agreement between tests was poor (<italic>κ</italic> = 0.20). Although positive results of both tests were significantly associated with older age (relative risks [RR] TST+, 1.64; 95% confidence interval [CI]: 1.36–1.97; RR QFT+, 3.05; 95% CI: 1.72–5.38) and with the presence of TB in at least 1 immigrating family member (RR TST+, 1.40; 95% CI: 1.12–1.75; RR QFT+ 2.24; 95% CI: 1.18–4.28), QFT+ results were more strongly associated with both predictive variables.</p> </sec> <sec> <title>Conclusions:</title> <p>The findings support the preferential use of QFT over TST for pre-immigration screening of foreign-born children 2 years of age and older and lend support to the preferential use of IGRAs in testing foreign-born children for latent TB infection.</p> </sec> </abstract>