Alexander W Kay1, Shamim M Islam2, Kristen Wendorf1, Janice Westenhouse1, Pennan M Barry3. 1. California Department of Public Health, Richmond, California; and. 2. University at Buffalo, State University of New York, Buffalo, New York. 3. California Department of Public Health, Richmond, California; and pennan.barry@cdph.ca.gov.
Abstract
BACKGROUND: Interferon-γ release assays (IGRAs) are important adjunctive tests for diagnosing tuberculosis (TB) disease in children. METHODS: We analyzed California TB registry data for patients ≤18 years with laboratory-confirmed TB disease during 2010-2015 to identify case characteristics associated with test selection and performance and measure IGRA sensitivity. RESULTS: In total, 778 cases of TB were reported; 360 were laboratory confirmed. Indeterminate IGRAs were associated with being <1 year old (prevalence rate ratio 9.23; 95% confidence interval 2.87 to 29.8) and having central nervous system disease (prevalence rate ratio 2.69; 95% confidence interval 1.06 to 6.86) on multivariable analysis. Ninety-five children had both an IGRA and tuberculin skin test (TST) performed. Among those, the sensitivity of IGRA in 5- to 18-year-olds was 96% (66 out of 69) vs 83% (57 out of 69) for TST (P = .01); IGRA sensitivity compared with TST in children ages 2 to 4 was 91% (10 out of 11) vs 91% (10 out of 11) (P > .99), and the sensitivity compared with TST in children aged <2 years was 80% (12 out of 15) vs 87% (13 out of 15) (P > .99). CONCLUSIONS: This is the largest North American analysis of IGRA use and performance among children with TB disease. In children <5 years old, IGRA sensitivity is similar to TST, but sensitivity of both tests are reduced in children <2 years old. Indeterminate results are higher in children <1 year old and in central nervous system disease. In children ≥5 years old with laboratory-confirmed TB, IGRA has greater sensitivity than TST and should be considered the preferred immunodiagnostic test..
BACKGROUND: Interferon-γ release assays (IGRAs) are important adjunctive tests for diagnosing tuberculosis (TB) disease in children. METHODS: We analyzed California TB registry data for patients ≤18 years with laboratory-confirmed TB disease during 2010-2015 to identify case characteristics associated with test selection and performance and measure IGRA sensitivity. RESULTS: In total, 778 cases of TB were reported; 360 were laboratory confirmed. Indeterminate IGRAs were associated with being <1 year old (prevalence rate ratio 9.23; 95% confidence interval 2.87 to 29.8) and having central nervous system disease (prevalence rate ratio 2.69; 95% confidence interval 1.06 to 6.86) on multivariable analysis. Ninety-five children had both an IGRA and tuberculin skin test (TST) performed. Among those, the sensitivity of IGRA in 5- to 18-year-olds was 96% (66 out of 69) vs 83% (57 out of 69) for TST (P = .01); IGRA sensitivity compared with TST in children ages 2 to 4 was 91% (10 out of 11) vs 91% (10 out of 11) (P > .99), and the sensitivity compared with TST in children aged <2 years was 80% (12 out of 15) vs 87% (13 out of 15) (P > .99). CONCLUSIONS: This is the largest North American analysis of IGRA use and performance among children with TB disease. In children <5 years old, IGRA sensitivity is similar to TST, but sensitivity of both tests are reduced in children <2 years old. Indeterminate results are higher in children <1 year old and in central nervous system disease. In children ≥5 years old with laboratory-confirmed TB, IGRA has greater sensitivity than TST and should be considered the preferred immunodiagnostic test..
Authors: Lena Ronge; Rosa Sloot; Karen Du Preez; Alexander W Kay; H Lester Kirchner; Harleen M S Grewal; Anna M Mandalakas; Anneke C Hesseling Journal: Pediatr Infect Dis J Date: 2021-08-01 Impact factor: 3.806
Authors: Vanessa Lucília Silveira de Medeiros; Fabiana Cristina Fulco Santos; Lílian Maria Lapa Montenegro; Maria da Conceição Silva; Valdênia Maria Oliveira de Souza; Reginaldo Gonçalvez de Lima Neto; Líbia Cristina Rocha Vilela Moura; Vera Magalhães Journal: PLoS One Date: 2020-12-03 Impact factor: 3.240
Authors: R Villar-Hernández; T Blauenfeldt; E García-García; B Muriel-Moreno; M L De Souza-Galvão; J P Millet; F Sabriá; A Sánchez-Montalvá; J Ruiz-Manzano; J Pilarte; M A Jiménez; C Centeno; C Martos; I Molina-Pinargote; Y D González-Díaz; J Santiago; A Cantos; I Casas; R M Guerola; C Prat; P Andersen; I Latorre; M Ruhwald; J Domínguez Journal: Sci Rep Date: 2020-08-06 Impact factor: 4.379