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Free Content Utility of the QuantiFERON®-TB Gold In-Tube assay for the diagnosis of tuberculosis in Moroccan children

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SETTING: The utility of interferon-gamma release assays (IGRAs), such as the QuantiFERON®-TB Gold In-Tube (QFT-GIT) test, in diagnosing active tuberculosis (TB) in children is unclear and depends on the epidemiological setting.

OBJECTIVE: To evaluate the performance of QFT-GIT for TB diagnosis in children living in Morocco, an intermediate TB incidence country with high bacille Calmette-Guérin vaccination coverage.

DESIGN: We prospectively recruited 109 Moroccan children hospitalised for clinically suspected TB, all of whom were tested using QFT-GIT.

RESULTS: For 81 of the 109 children, the final diagnosis was TB. The remaining 28 children did not have TB. QFT-GIT had a sensitivity of 66% (95%CI 52–77) for the diagnosis of TB, and a specificity of 100% (95%CI 88–100). The tuberculin skin test (TST) had lower sensitivity, at 46% (95%CI 33–60), and its concordance with QFT-GIT was limited (69%). Combining QFT-GIT and TST results increased sensitivity to 83% (95%CI 69–92).

CONCLUSION: In epidemiological settings such as those found in Morocco, QFT-GIT is more sensitive than the TST for active TB diagnosis in children. Combining the TST and QFT-GIT would be useful for the diagnosis of active TB in children, in combination with clinical, radiological and laboratory data.
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Keywords: BCG; IFN-γ release assays; QFT-GIT; TST; sensitivity; specificity; tuberculosis

Document Type: Research Article

Affiliations: 1: Genetics Unit, Mohammed V Military Hospital, Rabat, Faculty of Science–Kenitra IbnTofail University, Kenitra, Morocco 2: Ear, Nose, Throat Department, Head and Neck Surgery, Medical and Pharmacy School of Rabat, Mohammed V Military Hospital, University of Mohammed V, Rabat, Morocco 3: Department of Paediatrics, Mohammed V Military Hospital, Medical and Pharmacy School of Rabat, University of Mohammed V, Rabat, Morocco 4: Department of Paediatric Infectious Diseases, Rabat Children's Hospital, Rabat, Morocco 5: Department of Paediatrics, Mohammed V Military Hospital, Morocco 6: Department of Neurosurgery, Avicenne Military Hospital, Marrakech, University of Mohammed V Souissi, Rabat, Morocco 7: Genetics Unit, Mohammed V Military Hospital, Rabat, Faculty of Sciences of Rabat, University of Mohammed V, Rabat, Morocco 8: Medical and Pharmacy School of Rabat, University of Mohammed V, Rabat, Morocco; Department of Paediatric Infectious Diseases, Rabat Children's Hospital, Rabat, Morocco 9: Clinical Immunology Unit, Casablanca Children's Hospital, Ibn Rochd Medical School, Morocco 10: Department of Paediatric Infectious Diseases, Ibn Rochd Hospital University Centre, King Hassan II University, Casablanca, Morocco 11: Laboratory of Human Genetics of Infectious Diseases, Necker Branch, Institut National de la Santé et de la Recherche Médicale Unité 1163, Paris, France; Imagine Institute, Paris Descartes University, Paris, France 12: McGill Centre for the Study of Host Resistance, The Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada 13: Laboratory of Human Genetics of Infectious Diseases, Necker Branch, Institut National de la Santé et de la Recherche Médicale Unité 1163, Paris, France; Imagine Institute, Paris Descartes University, Paris, France; Center for the Study of Primary Immunodeficiencies, Assistance Publique-Hôpitaux de Paris (AP-HP), Necker Hospital, Paris, France 14: Laboratory of Human Genetics of Infectious Diseases, Necker Branch, Institut National de la Santé et de la Recherche Médicale Unité 1163, Paris, France, Imagine Institute, Paris Descartes University, Paris, France; St Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, USA; Howard Hughes Medical Institute, New York, New York, USA; Paediatric Haematology-Immunology Unit, AP-HP, Necker Hospital, Paris, France 15: Laboratory of Human Genetics of Infectious Diseases, Necker Branch, Institut National de la Santé et de la Recherche Médicale Unité 1163, Paris, France, Imagine Institute, Paris Descartes University, Paris, France; St Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, USA 16: Genetics Unit, Mohammed V Military Hospital, Rabat, Morocco

Publication date: December 1, 2016

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  • 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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