Role of confirmatory interferon-gamma release assays in school outbreaks of tuberculosis in South Korea.
Int J Tuberc Lung Dis
; 19(5): 576-81, 2015 May.
Article
in En
| MEDLINE
| ID: mdl-25868027
ABSTRACT
OBJECTIVE:
To investigate the usefulness of confirmatory QuantiFERON(®) (QFT) testing among tuberculin skin test (TST) positive contacts to diagnose latent tuberculous infection (LTBI) in tuberculosis (TB) outbreaks among adolescents.DESIGN:
We used the Korean national claims database to identify the development of active TB disease in relation to initial TST (cut-off 10 mm induration) and subsequent QFT results.RESULTS:
A total of 7475 contacts in 89 schools were divided into four groups TST- (n = 5714), TST+/QFT+ (n = 534), TST+/QFT- (n = 697) and TST+ only (n = 530). The mean duration of follow-up was 3.9 ± 0.9 years. For contacts with no LTBI treatment (n = 6868), TB incidence rates per 1000 person-years (py) and the adjusted hazard ratio (HR) compared with TST- individuals were as follows TST+/QFT+, 66.2/1000 py (HR 35.59, 95%CI 14.03-90.31, P < 0.001); TST+ only, 10.1/1000 py (HR 5.16, 95%CI 2.91-9.17, P < 0.001); TST+/QFT-, 4.0/1000 py (HR 2.05, 95%CI 1.05-4.01, P = 0.035); and TST- 2.0/1000 py. The TB progression rate was significantly higher in TST+/QFT+ than in TST+/QFT- individuals (HR 16.82, 95 CI 5.84-48.46, P < 0.001).CONCLUSION:
A confirmatory QFT for TST+ contacts could reduce the number of candidates for LTBI treatment after school TB outbreaks.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Tuberculosis, Pulmonary
/
Disease Outbreaks
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Latent Tuberculosis
/
Interferon-gamma Release Tests
Type of study:
Clinical_trials
/
Incidence_studies
/
Prognostic_studies
Limits:
Adolescent
/
Adult
/
Child
/
Female
/
Humans
/
Male
Country/Region as subject:
Asia
Language:
En
Journal:
Int J Tuberc Lung Dis
Year:
2015
Document type:
Article