Factors Associated with the Performance of a Blood-Based Interferon-γ Release Assay in Diagnosing Tuberculosis
Factors Associated with the Performance of a Blood-Based Interferon-γ Release Assay in Diagnosing Tuberculosis
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DOI：
10.1371/journal.pone.0038556
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发表时间：
2012-06-12
期刊：
影响因子：
3.7
通讯作者：
Burgner, David
中科院分区：
文献类型：
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作者：
Banfield, Sally;Pascoe, Elaine;Burgner, David
背景：不确定的结果是干扰素-c 释放测定 (IGRA) 在诊断潜伏性结核 (TB) 感染 (LTBI) 和结核病（尤其是儿童）中的公认局限性。我们在未经选择的重新安置难民队列中调查了年龄和常见合并症是否与 IGRA 表现相关。方法：对 2006 年和 2007 年进行重新安置后健康评估的难民进行回顾性横断面研究。作为标准临床筛查方案的一部分，对难民进行了流行传染病（包括结核病）以及常见营养缺乏和血液学异常的调查。结核病筛查由 IGRA 进行； 2006 年的 QuantiFERON-TB Gold 和 2007 年的 QuantiFERON-TBGold In-Tube。 结果：获得了 1130 名难民的完整数据，其中 573 名 (51%) 是 17 岁以下的儿童，1041 名 (92%) 来自撒哈拉以南非洲。所有个体的艾滋病毒均为阴性。 1004 名（89%）难民获得了最终的 IGRA 结果，其中 264 名（26%）呈阳性； 256 人 (97%) 患有 LTBI，8 人 (3%) 患有结核病。 126 名 (11%) 难民获得了不确定的 IGRA 结果（均未通过阳性有丝分裂原控制）。在多变量分析中，年龄较小（线性 OR = 0.93 [95% CI 0.91-0.95]，P
Background: Indeterminate results are a recognised limitation of interferon-c release assays (IGRA) in the diagnosis of latent tuberculosis (TB) infection (LTBI) and TB disease, especially in children. We investigated whether age and common comorbidities were associated with IGRA performance in an unselected cohort of resettled refugees.Methods: A retrospective cross-sectional study of refugees presenting for their post-resettlement health assessment during 2006 and 2007. Refugees were investigated for prevalent infectious diseases, including TB, and for common nutritional deficiencies and haematological abnormalities as part of standard clinical screening protocols. Tuberculosis screening was performed by IGRA; QuantiFERON-TB Gold in 2006 and QuantiFERON-TBGold In-Tube in 2007.Results: Complete data were available on 1130 refugees, of whom 573 (51%) were children less than 17 years and 1041 (92%) were from sub-Saharan Africa. All individuals were HIV negative. A definitive IGRA result was obtained in 1004 (89%) refugees, 264 (26%) of which were positive; 256 (97%) had LTBI and 8 (3%) had TB disease. An indeterminate IGRA result was obtained in 126 (11%) refugees (all failed positive mitogen control). In multivariate analysis, younger age (linear OR = 0.93 [95% CI 0.91-0.95], P