Cough Aerosol Cultures of Mycobacterium tuberculosis: Insights on TST / IGRA Discordance and Transmission Dynamics.
The diagnosis of latent tuberculosis (TB) infection (LTBI) is complicated by the absence of a gold standard. Discordance between tuberculin skin tests (TST) and interferon gamma release assays (IGRA) occurs in 10-20% of individuals, but the underlying mechanisms are poorly understood.We analyzed dat...
| Main Authors: | , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Public Library of Science (PLoS)
2015-01-01
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| Series: | PLoS ONE |
| Online Access: | http://europepmc.org/articles/PMC4578948?pdf=render |
| _version_ | 1818179800271945728 |
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| author | Edward C Jones-López Laura F White Bruce Kirenga Francis Mumbowa Martin Ssebidandi Stephanie Moine Olive Mbabazi Gerald Mboowa Irene Ayakaka Soyeon Kim Christina S Thornton Alphonse Okwera Moses Joloba Kevin P Fennelly |
| author_facet | Edward C Jones-López Laura F White Bruce Kirenga Francis Mumbowa Martin Ssebidandi Stephanie Moine Olive Mbabazi Gerald Mboowa Irene Ayakaka Soyeon Kim Christina S Thornton Alphonse Okwera Moses Joloba Kevin P Fennelly |
| author_sort | Edward C Jones-López |
| collection | DOAJ |
| description | The diagnosis of latent tuberculosis (TB) infection (LTBI) is complicated by the absence of a gold standard. Discordance between tuberculin skin tests (TST) and interferon gamma release assays (IGRA) occurs in 10-20% of individuals, but the underlying mechanisms are poorly understood.We analyzed data from a prospective household contact study that included cough aerosol culture results from index cases, environmental and contact factors. We assessed contacts for LTBI using TST and IGRA at baseline and six weeks. We examined TST/IGRA discordance in qualitative and quantitative analyses, and used multivariable logistic regression analysis with generalized estimating equations to analyze predictors of discordance.We included 96 TB patients and 384 contacts. Discordance decreased from 15% at baseline to 8% by six weeks. In adjusted analyses, discordance was related to less crowding (p = 0.004), non-cavitary disease (OR 1.41, 95% CI: 1.02-1.96; p = 0.03), and marginally with BCG vaccination in contacts (OR 1.40, 95% CI: 0.99-1.98, p = 0.06).We observed significant individual variability and temporal dynamism in TST and IGRA results in household contacts of pulmonary TB cases. Discordance was associated with a less intense infectious exposure, and marginally associated with a BCG-mediated delay in IGRA conversion. Cough aerosols provide an additional dimension to the assessment of infectiousness and risk of infection in contacts. |
| first_indexed | 2024-12-11T21:09:38Z |
| format | Article |
| id | doaj.art-300ff72f40d04e7eb55a65a04869a791 |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-12-11T21:09:38Z |
| publishDate | 2015-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-300ff72f40d04e7eb55a65a04869a7912022-12-22T00:50:46ZengPublic Library of Science (PLoS)PLoS ONE1932-62032015-01-01109e013835810.1371/journal.pone.0138358Cough Aerosol Cultures of Mycobacterium tuberculosis: Insights on TST / IGRA Discordance and Transmission Dynamics.Edward C Jones-LópezLaura F WhiteBruce KirengaFrancis MumbowaMartin SsebidandiStephanie MoineOlive MbabaziGerald MboowaIrene AyakakaSoyeon KimChristina S ThorntonAlphonse OkweraMoses JolobaKevin P FennellyThe diagnosis of latent tuberculosis (TB) infection (LTBI) is complicated by the absence of a gold standard. Discordance between tuberculin skin tests (TST) and interferon gamma release assays (IGRA) occurs in 10-20% of individuals, but the underlying mechanisms are poorly understood.We analyzed data from a prospective household contact study that included cough aerosol culture results from index cases, environmental and contact factors. We assessed contacts for LTBI using TST and IGRA at baseline and six weeks. We examined TST/IGRA discordance in qualitative and quantitative analyses, and used multivariable logistic regression analysis with generalized estimating equations to analyze predictors of discordance.We included 96 TB patients and 384 contacts. Discordance decreased from 15% at baseline to 8% by six weeks. In adjusted analyses, discordance was related to less crowding (p = 0.004), non-cavitary disease (OR 1.41, 95% CI: 1.02-1.96; p = 0.03), and marginally with BCG vaccination in contacts (OR 1.40, 95% CI: 0.99-1.98, p = 0.06).We observed significant individual variability and temporal dynamism in TST and IGRA results in household contacts of pulmonary TB cases. Discordance was associated with a less intense infectious exposure, and marginally associated with a BCG-mediated delay in IGRA conversion. Cough aerosols provide an additional dimension to the assessment of infectiousness and risk of infection in contacts.http://europepmc.org/articles/PMC4578948?pdf=render |
| spellingShingle | Edward C Jones-López Laura F White Bruce Kirenga Francis Mumbowa Martin Ssebidandi Stephanie Moine Olive Mbabazi Gerald Mboowa Irene Ayakaka Soyeon Kim Christina S Thornton Alphonse Okwera Moses Joloba Kevin P Fennelly Cough Aerosol Cultures of Mycobacterium tuberculosis: Insights on TST / IGRA Discordance and Transmission Dynamics. PLoS ONE |
| title | Cough Aerosol Cultures of Mycobacterium tuberculosis: Insights on TST / IGRA Discordance and Transmission Dynamics. |
| title_full | Cough Aerosol Cultures of Mycobacterium tuberculosis: Insights on TST / IGRA Discordance and Transmission Dynamics. |
| title_fullStr | Cough Aerosol Cultures of Mycobacterium tuberculosis: Insights on TST / IGRA Discordance and Transmission Dynamics. |
| title_full_unstemmed | Cough Aerosol Cultures of Mycobacterium tuberculosis: Insights on TST / IGRA Discordance and Transmission Dynamics. |
| title_short | Cough Aerosol Cultures of Mycobacterium tuberculosis: Insights on TST / IGRA Discordance and Transmission Dynamics. |
| title_sort | cough aerosol cultures of mycobacterium tuberculosis insights on tst igra discordance and transmission dynamics |
| url | http://europepmc.org/articles/PMC4578948?pdf=render |
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