Comparison of the tuberculin skin test and the QuantiFERON-TB Gold test in detecting latent tuberculosis in health care workers in Iran
1
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
OBJECTIVES: The tuberculin skin test (TST) and the QuantiFERON-TB Gold test (QFT) are used to identify latent tuberculosis infections (LTBIs). The aim of this study was to determine the agreement between these two tests among health care workers in Iran. METHODS: This cross-sectional study included 177 tuberculosis (TB) laboratory staff and 67 non-TB staff. TST indurations of 10 mm or more were considered positive. The Student’s t-test and the chi-square test were used to compare the mean score and proportion of variables between the TB laboratory staff and the non-TB laboratory staff. Kappa statistics were used to evaluate the agreement between these tests, and logistic regression was used to assess the risk factors associated with positive results for each test. RESULTS: The prevalence of LTBIs according to both the QFT and the TST was 17% (95% confidence interval [CI], 12% to 21%) and 16% (95% CI, 11% to 21%), respectively. The agreement between the QFT and the TST was 77.46%, with a kappa of 0.19 (95% CI, 0.04 to 0.34). CONCLUSIONS: Although the prevalence of LTBI based on the QFT and the TST was not significantly different, the kappa statistic was low between these two tests for the detection of LTBIs.
Abstract
OBJECTIVES: The tuberculin skin test (TST) and the QuantiFERON-TB Gold test (QFT) are used to identify latent tuberculosis infections (LTBIs). The aim of this study was to determine the agreement between these two tests among health care workers in Iran. METHODS: This cross-sectional study included 177 tuberculosis (TB) laboratory staff and 67 non-TB staff. TST indurations of 10 mm or more were considered positive. The Student’s t-test and the chi-square test were used to compare the mean score and proportion of variables between the TB laboratory staff and the non-TB laboratory staff. Kappa statistics were used to evaluate the agreement between these tests, and logistic regression was used to assess the risk factors associated with positive results for each test. RESULTS: The prevalence of LTBIs according to both the QFT and the TST was 17% (95% confidence interval [CI], 12% to 21%) and 16% (95% CI, 11% to 21%), respectively. The agreement between the QFT and the TST was 77.46%, with a kappa of 0.19 (95% CI, 0.04 to 0.34). CONCLUSIONS: Although the prevalence of LTBI based on the QFT and the TST was not significantly different, the kappa statistic was low between these two tests for the detection of LTBIs.
참고문헌 (27)
- "Tuberculosis: fact sheet no. 104" (2012)[URL]
- Comstock GW, "The prognosis of a positive tuberculin reaction in childhood and adolescence", Am J Epidemiol, 99, pp.131~138 (1974)
- Fitzgerald DW, "Mandell, Douglas, and Bennett’s principles and practice of infectious diseases", pp.3129~3159 (2010), Elsevier
- Farhat M, "False-positive tuberculin skin tests: what is the absolute effect of BCG and non-tuberculous mycobacteria?", Int J Tuberc Lung Dis, 10, pp.1192~1204 (2006)
- Lee E, "Evolution and current use of the tuberculin test", Clin Infect Dis, 34, pp.365~370 (2002)
- Huebner RE, "The tuberculin skin test", Clin Infect Dis, 17, pp.968~975 (1993)
- Nayak S, "Mantoux test and its interpretation", Indian Dermatol Online J, 3, pp.2~6 (2012)
- Mazurek GH, "Guidelines for using the QuantiFERON-TB Gold test for detecting Mycobacterium tuberculosis infection, United States", MMWR Recomm Rep, 54, pp.49~55 (2005)
- Mazurek GH, "Updated guidelines for using interferon gamma release assays to detect Mycobacterium tuberculosis infection - United States, 2010", MMWR Recomm Rep, 59, pp.1~25 (2010)
- Menzies D, "Meta-analysis: new tests for the diagnosis of latent tuberculosis infection: areas of uncertainty and recommendations for research", Ann Intern Med, 146, pp.340~354 (2007)
- Pollock NR, "Discordant QuantiFERON-TB Gold test results among US healthcare workers with increased risk of latent tuberculosis infection: a problem or solution?", Infect Control Hosp Epidemiol, 29, pp.878~886 (2008)
- Talati NJ, "Poor concordance between interferon-gamma release assays and tuberculin skin tests in diagnosis of latent tuberculosis infection among HIV-infected individuals", BMC Infect Dis, 9, pp.15~ (2009)
- Chkhartishvili N, "Poor agreement between interferon-gamma release assays and the tuberculin skin test among HIV-infected individuals in the country of Georgia", BMC Infect Dis, 13, pp.513~ (2013)
- Connell TG, "A three-way comparison of tuberculin skin testing, QuantiFERON-TB gold and T-SPOT.TB in children", PLoS One, 3, pp.e2624~ (2008)
- Swindells JE, "Role of interferon-gamma release assays in healthcare workers", J Hosp Infect, 73, pp.101~108 (2009)
- Szklo M, "Epidemiology: beyond the basics", pp.338~340 (2014), Jones & Bartlett Learning
- Hashemi Shahri M, "To compare the performance of Quanti-FERON with the tuberculin skin test for identifying latent tuberculosis infection", Iran J Epidemiol, 7, pp.57~65 (2012)
- Mirhaghani L, "National tuberculosis program in Iran", pp.15~20 (2002), Ministry of Health (Nashr-e Seda)
- Khazaei HA, "Epidemiology of tuberculosis in the Southeastern Iran", Eur J Epidemiol, 20, pp.879~883 (2005)
- Rafiee S, "Epidemiology of tuberculosis in northeast of Iran : a population-based study", Iran J Med Sci, 34, pp.193~197 (2009)
- Sofian M, "Epidemiology of tuberculosis in Arak, Iran", Faslnamahi Kumish, 10, pp.261~266 (2009)
- Sim J, "and sample size requirements", Phys Ther, 85, pp.257~268 (2005)
- Tripodi D, "Evaluation of the tuberculin skin test and the interferon-gamma release assay for TB screening in French healthcare workers", J Occup Med Toxicol, 4, pp.30~ (2009)
- Ozdemir D, "Comparison of the tuberculin skin test and the quantiferon test for latent Mycobacterium tuberculosis infections in health care workers in Turkey", Jpn J Infect Dis, 60, pp.102~105 (2007)
- 조경욱, "Prevalence of Latent Tuberculosis Infection among Health Care Workers in South Korea: A Multicenter Study", Tuberculosis and Respiratory Diseases, 75(1), pp.18~24 (2013), 대한결핵및호흡기학회
- Dorman SE, "Interferon-γ release assays and tuberculin skin testing for diagnosis of latent tuberculosis infection in healthcare workers in the United States", Am J Respir Crit Care Med, 189, pp.77~87 (2014)
- Doosti-Irani A, "Tuberculin and QuantiFERON-TB-Gold tests for latent tuberculosis : a meta-analysis", Occup Med(Lond), 66, pp.437~445 (2016)