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Free Content Comparison of Mantoux skin test with three generations of a whole blood IFN-γ assay for tuberculosis infection

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Abstract:

SETTING: A rural town in South Africa.

OBJECTIVE: To compare the performance of QuantiFERON assays with the tuberculin skin test (TST) for identifying latent tuberculosis infection (LTBI) in a high TB burden community.

DESIGN: In a cross-sectional study in healthy adults, we applied the TST and took blood for the three generations of QuantiFERON assays.

RESULTS: Of 358 participants whose results were analysed, 291 (81%) had a TST result of ≥10 mm induration, and 187 (52%) ≥15 mm. QuantiFERON-TB was positive in 215 (60%), QuantiFERON-TB Gold in 137 (38%), and QuantiFERON-TB Gold (In-Tube method) in 201 (56%). There was poor agreement between TST and QuantiFERON tests, and between the different generations of QuantiFERON tests (κ = 0.12–0.50). Of the subset with TST indurations ≥15 mm, 30–56% had negative QuantiFERON tests. However, positive QuantiFERON tests were associated with males, who have a higher incidence of TB in this area.

CONCLUSION: We showed poor agreement between TST and the different QuantiFERON tests in diagnosing LTBI. The surprising discordance between the QuantiFERON TB Gold and QuantiFERON TB Gold (In-Tube method) tests needs to be investigated further.

Keywords: diagnosis; interferon-gamma; tuberculin skin test; tuberculosis

Document Type: Regular Paper

Affiliations: 1: South African Tuberculosis Vaccine Initiative, Institute of Infectious Disease and Molecular Medicine, Cape Town, South Africa; and School of Child and Adolescent Health, Cape Town, South Africa 2: School of Child and Adolescent Health, University of Cape Town, Cape Town, South Africa 3: Department of Statistical Sciences, University of Cape Town, Cape Town, South Africa 4: Aeras Global Tuberculosis Vaccine Foundation, Bethesda, Maryland, USA

Publication date: March 1, 2006

More about this publication?
  • The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.

    Certain IJTLD articles are selected for translation into French, Spanish, Chinese or Russian. They are available on the Union website

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