Comparison of IGRA and TST in the diagnosis of latent tuberculosis among women of reproductive age in South India.


Journal

The Indian journal of tuberculosis
ISSN: 0019-5707
Titre abrégé: Indian J Tuberc
Pays: India
ID NLM: 0373027

Informations de publication

Date de publication:
Jan 2023
Historique:
received: 17 08 2021
accepted: 09 03 2022
entrez: 5 2 2023
pubmed: 6 2 2023
medline: 8 2 2023
Statut: ppublish

Résumé

Latent tuberculosis infection (LTBI) is a mycobacterial infection defined on the basis of cellular immune response to mycobacterial antigens. The tuberculin skin test (TST) and the Interferon-Gamma Release Assay (IGRA) are the two tests currently used to establish the diagnosis of LTB. Literature suggests that a study regarding tuberculosis (TB) infection among women of reproductive age group is limited. Female household contact, married, aged 18-49 years underwent written consent form and are screened for LTBI using the TST and IGRA. Participants are injected with TST [5 tuberculin unit (TU), purified protein derivative (PPD)] and IGRA [QuantiFERON®-TB Gold Plus kit (QFT-Plus)]. All the household contacts were followed-up for one year for incident TB cases. Statistical analysis was done using STATA version 14 (StataCorp., Texas, USA). Cohen's kappa test was used to determine the agreement between two tests. The prevalence of LTBI was found to be 69% (either TST or IGRA positive). Positivity rate of IGRA was higher when compared to that of TST. Out of 139 participants, 68 (49%) tested positive for TST, 80 (57.6%) tested positive for IGRA and 52 (37.4%) tested positive for both. Discordant results were observed in about two fifth of the study population and there was poor agreement between the two tests. Longitudinal studies are required to detect incident TB cases to evaluate the usefulness of these tests. The study was found that IGRA is more consistent to diagnosis of latent tuberculosis infection than the TST. Such studies can also be performed in varied settings among different populations which would help us to improve the diagnosis of LTBI and consequently help in TB control.

Sections du résumé

BACKGROUND BACKGROUND
Latent tuberculosis infection (LTBI) is a mycobacterial infection defined on the basis of cellular immune response to mycobacterial antigens. The tuberculin skin test (TST) and the Interferon-Gamma Release Assay (IGRA) are the two tests currently used to establish the diagnosis of LTB. Literature suggests that a study regarding tuberculosis (TB) infection among women of reproductive age group is limited.
METHODS METHODS
Female household contact, married, aged 18-49 years underwent written consent form and are screened for LTBI using the TST and IGRA. Participants are injected with TST [5 tuberculin unit (TU), purified protein derivative (PPD)] and IGRA [QuantiFERON®-TB Gold Plus kit (QFT-Plus)]. All the household contacts were followed-up for one year for incident TB cases. Statistical analysis was done using STATA version 14 (StataCorp., Texas, USA). Cohen's kappa test was used to determine the agreement between two tests.
RESULTS RESULTS
The prevalence of LTBI was found to be 69% (either TST or IGRA positive). Positivity rate of IGRA was higher when compared to that of TST. Out of 139 participants, 68 (49%) tested positive for TST, 80 (57.6%) tested positive for IGRA and 52 (37.4%) tested positive for both. Discordant results were observed in about two fifth of the study population and there was poor agreement between the two tests.
CONCLUSION CONCLUSIONS
Longitudinal studies are required to detect incident TB cases to evaluate the usefulness of these tests. The study was found that IGRA is more consistent to diagnosis of latent tuberculosis infection than the TST. Such studies can also be performed in varied settings among different populations which would help us to improve the diagnosis of LTBI and consequently help in TB control.

Identifiants

pubmed: 36740307
pii: S0019-5707(22)00040-3
doi: 10.1016/j.ijtb.2022.03.011
pii:
doi:

Types de publication

Journal Article Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

12-16

Informations de copyright

Copyright © 2022 Tuberculosis Association of India. Published by Elsevier B.V. All rights reserved.

Déclaration de conflit d'intérêts

Conflicts of interest The authors have none to declare.

Auteurs

Senbagavalli Prakash Babu (S)

Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India. Electronic address: prco.manuscript@gmail.com.

Komala Ezhumalai (K)

Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India.

Kalaivani Raghupathy (K)

Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India.

Madhusudanan Sundaresan (M)

Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India.

Komal Jain (K)

Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India.

Prakash Babu Narasimhan (PB)

Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India.

Selby Knudsen (S)

Department of Medicine, Section of Infectious Diseases, Boston University School of Medicine, Boston, MA, USA.

C Robert Horsburgh (CR)

Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA.

Natasha S Hochberg (NS)

Department of Medicine, Section of Infectious Diseases, Boston University School of Medicine, Boston, MA, USA.

Padmini Salgame (P)

Department of Medicine, Rutgers New Jersey Medical School, Newark, NJ, USA.

Jerrold Ellner (J)

Department of Medicine, Rutgers New Jersey Medical School, Newark, NJ, USA.

Sonali Sarkar (S)

Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India.

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