Utility of the QuantiFERON®-TB Gold In-Tube assay for the diagnosis of tuberculosis in Moroccan children
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.
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: 01 December 2016
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