Comparison of tuberculin skin test and QuantiFERON-TB Gold In-Tube test in Bacillus Calmette–Guerin-vaccinated children
Objectives: The aim of this study is to determine the concordance between QuantiFERON-TB Gold In-Tube (QFT-GIT) and tuberculin skin test (TST) in children vaccinated with Bacillus Calmette–Guerin (BCG). Methods: This cross-sectional study was done at a pediatric tertiary care center in 33 BCG-vaccin...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2020-01-01
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| Series: | Lung India |
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| Online Access: | http://www.lungindia.com/article.asp?issn=0970-2113;year=2020;volume=37;issue=1;spage=24;epage=29;aulast=Shah |
| _version_ | 1818278993913184256 |
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| author | Ira Shah Jagdish Kathwate Naman S Shetty |
| author_facet | Ira Shah Jagdish Kathwate Naman S Shetty |
| author_sort | Ira Shah |
| collection | DOAJ |
| description | Objectives: The aim of this study is to determine the concordance between QuantiFERON-TB Gold In-Tube (QFT-GIT) and tuberculin skin test (TST) in children vaccinated with Bacillus Calmette–Guerin (BCG). Methods: This cross-sectional study was done at a pediatric tertiary care center in 33 BCG-vaccinated children aged 6 months–15 years suspected of Mycobacterium tuberculosis infection or in contact with a patient with open tuberculosis (TB). All patients were tested for TST with purified protein derivative-S 5 tuberculin units and QFT-GIT assays. Concordance was evaluated between TST and QFT assay by kappa coefficient (k). Agreement between the tests was classified into categories: poor if k < 0.20, fair (k = 0.21–0.40), moderate (k = 0.41–0.60), good (k = 0.61–0.80), and very good (k = 0.81–1.00). Results: Both the TST and QFT assay were positive in 13 and negative in eight children, respectively, resulting in an agreement of 63% (κ = 0.31). Eight children were <4 years of age of which only one patient had a positive TST and QFT-GIT, and TST and QFT-GIT were negative in two patients resulting in an agreement of 37.5% (κ = 0.063). Among children 4 years of age and older, 12 patients had a positive TST and QFT-GIT and 6 patients had a negative TST and QFT-GIT resulting in an agreement of 72% (κ = 0.41). Among 12 children who had been in contact with an adult having open TB, both the TST and QFT-GIT were positive in 6 patients and negative in two patients, respectively, resulting in an agreement of 66% (κ = 0.41). TST specificity was only 29.6% with a positive predictive value of 42.4% as compared to QFT-GIT. Among children <4 years of age, TST specificity was only 28.6% with a positive predictive rate of 16.7%, and among children >4 years of age, TST specificity was 50% with a positive predictive value of 66.7%. In patients with contact with a patient having TB, TST specificity was 33.3%. Considering TST of 15 mm and above as positive, TST specificity increased to 63.2% and a positive predictive value was 56.3%. Conclusion: The concordance of TST and QFT-GIT is low in children with previous BCG vaccination and especially in children <4 years of age. QFT-GIT may help to rule out false-positive TST. |
| first_indexed | 2024-12-12T23:26:16Z |
| format | Article |
| id | doaj.art-f3e95a5d0331455c8be51252383aea99 |
| institution | Directory Open Access Journal |
| issn | 0970-2113 0974-598X |
| language | English |
| last_indexed | 2024-12-12T23:26:16Z |
| publishDate | 2020-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Lung India |
| spelling | doaj.art-f3e95a5d0331455c8be51252383aea992022-12-22T00:08:03ZengWolters Kluwer Medknow PublicationsLung India0970-21130974-598X2020-01-01371242910.4103/lungindia.lungindia_304_19Comparison of tuberculin skin test and QuantiFERON-TB Gold In-Tube test in Bacillus Calmette–Guerin-vaccinated childrenIra ShahJagdish KathwateNaman S ShettyObjectives: The aim of this study is to determine the concordance between QuantiFERON-TB Gold In-Tube (QFT-GIT) and tuberculin skin test (TST) in children vaccinated with Bacillus Calmette–Guerin (BCG). Methods: This cross-sectional study was done at a pediatric tertiary care center in 33 BCG-vaccinated children aged 6 months–15 years suspected of Mycobacterium tuberculosis infection or in contact with a patient with open tuberculosis (TB). All patients were tested for TST with purified protein derivative-S 5 tuberculin units and QFT-GIT assays. Concordance was evaluated between TST and QFT assay by kappa coefficient (k). Agreement between the tests was classified into categories: poor if k < 0.20, fair (k = 0.21–0.40), moderate (k = 0.41–0.60), good (k = 0.61–0.80), and very good (k = 0.81–1.00). Results: Both the TST and QFT assay were positive in 13 and negative in eight children, respectively, resulting in an agreement of 63% (κ = 0.31). Eight children were <4 years of age of which only one patient had a positive TST and QFT-GIT, and TST and QFT-GIT were negative in two patients resulting in an agreement of 37.5% (κ = 0.063). Among children 4 years of age and older, 12 patients had a positive TST and QFT-GIT and 6 patients had a negative TST and QFT-GIT resulting in an agreement of 72% (κ = 0.41). Among 12 children who had been in contact with an adult having open TB, both the TST and QFT-GIT were positive in 6 patients and negative in two patients, respectively, resulting in an agreement of 66% (κ = 0.41). TST specificity was only 29.6% with a positive predictive value of 42.4% as compared to QFT-GIT. Among children <4 years of age, TST specificity was only 28.6% with a positive predictive rate of 16.7%, and among children >4 years of age, TST specificity was 50% with a positive predictive value of 66.7%. In patients with contact with a patient having TB, TST specificity was 33.3%. Considering TST of 15 mm and above as positive, TST specificity increased to 63.2% and a positive predictive value was 56.3%. Conclusion: The concordance of TST and QFT-GIT is low in children with previous BCG vaccination and especially in children <4 years of age. QFT-GIT may help to rule out false-positive TST.http://www.lungindia.com/article.asp?issn=0970-2113;year=2020;volume=37;issue=1;spage=24;epage=29;aulast=Shahchildrenmantoux testquantiferontuberculin skin test |
| spellingShingle | Ira Shah Jagdish Kathwate Naman S Shetty Comparison of tuberculin skin test and QuantiFERON-TB Gold In-Tube test in Bacillus Calmette–Guerin-vaccinated children Lung India children mantoux test quantiferon tuberculin skin test |
| title | Comparison of tuberculin skin test and QuantiFERON-TB Gold In-Tube test in Bacillus Calmette–Guerin-vaccinated children |
| title_full | Comparison of tuberculin skin test and QuantiFERON-TB Gold In-Tube test in Bacillus Calmette–Guerin-vaccinated children |
| title_fullStr | Comparison of tuberculin skin test and QuantiFERON-TB Gold In-Tube test in Bacillus Calmette–Guerin-vaccinated children |
| title_full_unstemmed | Comparison of tuberculin skin test and QuantiFERON-TB Gold In-Tube test in Bacillus Calmette–Guerin-vaccinated children |
| title_short | Comparison of tuberculin skin test and QuantiFERON-TB Gold In-Tube test in Bacillus Calmette–Guerin-vaccinated children |
| title_sort | comparison of tuberculin skin test and quantiferon tb gold in tube test in bacillus calmette guerin vaccinated children |
| topic | children mantoux test quantiferon tuberculin skin test |
| url | http://www.lungindia.com/article.asp?issn=0970-2113;year=2020;volume=37;issue=1;spage=24;epage=29;aulast=Shah |
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