Comparison of IGRA and TST in the diagnosis of latent tuberculosis among women of reproductive age in South India

Babu, Senbagavalli Prakash; Ezhumalai, Komala; Raghupathy, Kalaivani; Sundaresan, Madhusudanan; Jain, Komal; Narasimhan, Prakash Babu; Knudsen, Selby; Horsburgh, C. Robert; Hochberg, Natasha S.; Salgame, Padmini; Ellner, Jerrold J.; Sarkar, Sonali

doi:10.1016/j.ijtb.2022.03.011

Cited by 2 publications

(2 citation statements)

References 22 publications

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“…The prevalence of TBI in our study was 22.9%, which is a little less than the pooled prevalence of positive tests for TBI found across studies conducted in low- and middle-income countries (LMICs), which ranges from 41 to 69% [ 8 , 11 , 12 , 13 , 14 ]. This difference may be attributed to specific factors, including the inclusion of only HHCs of PTB patients (both microbiologically and clinically confirmed) and not of high-risk groups, and use of only IGRA, not TST.…”

Section: Discussioncontrasting

confidence: 68%

Test and Treat Model for Tuberculosis Preventive Treatment among Household Contacts of Pulmonary Tuberculosis Patients in Selected Districts of Maharashtra: A Mixed-Methods Study on Care Cascade, Timeliness, and Early Implementation Challenges

Mahajan,

Soundappan,

Singla

et al. 2023

TropicalMed

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Tuberculosis preventive treatment (TPT) is an important intervention in preventing infection and reducing TB incidence among household contacts (HHCs). A mixed-methods study was conducted to assess the “Test and Treat” model of TPT care cascade among HHCs aged ≥5 years of pulmonary tuberculosis (PTB) patients (bacteriologically/clinically confirmed) being provided TPT care under Project Axshya Plus implemented in Maharashtra (India). A quantitative phase cohort study based on record review and qualitative interviews to understand the challenges and solutions in the TPT care cascade were used. Of the total 4181 index patients, 14,172 HHCs were screened, of whom 36 (0.3%) HHCs were diagnosed with tuberculosis. Among 14,133 eligible HHCs, 10,777 (76.3%) underwent an IGRA test. Of them, 2468 (22.9%) tested positive for IGRA and were suggested for chest X-ray. Of the eligible 2353 HHCs, 2159 (91.7%) were started on TPT, of whom 1958 (90.6%) completed the treatment. The median time between treatment initiation of index PTB patient and (a) HHC screening was 31 days; (b) TPT initiation was 64 days. The challenges in and suggested solutions for improving the TPT care cascade linked to subthemes were tuberculosis infection testing, chest X-ray, human resources, awareness and engagement, accessibility to healthcare facilities, TPT drugs, follow-up, and assessment. A systematic monitoring and time-based evaluation of TPT cascade care delivery followed by prompt corrective actions/interventions could be a crucial strategy for its effective implementation and for the prevention of tuberculosis.

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Section: Discussioncontrasting

confidence: 68%

Test and Treat Model for Tuberculosis Preventive Treatment among Household Contacts of Pulmonary Tuberculosis Patients in Selected Districts of Maharashtra: A Mixed-Methods Study on Care Cascade, Timeliness, and Early Implementation Challenges

Mahajan,

Soundappan,

Singla

et al. 2023

TropicalMed

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“…TST and IGRA (QFT-Plus or QuantiFERON-TB ® Gold In-Tube [QFT-GIT]) positivity rates vary in high-burden countries. 21 , 22 , 25 One study in India 26 showed a TBI prevalence of 71% among household contacts tested with both QFT-GIT and TST (⩾5 mm and ⩾10 mm). Neither QFT-GIT nor TST at either threshold predicted incident TB disease after 24 months.…”

Section: Discussionmentioning

confidence: 99%

Tuberculin skin testing and QuantiFERON™-TB Gold Plus positivity among household contacts in Vietnam

Innes,

Nguyen,

Lebrun

et al. 2023

public health action

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SETTING: TB infection (TBI) is diagnosed using the technique-dependent tuberculin skin test (TST) or costly, more accurate interferon-gamma release assays. The TST (10 mm) threshold was indicated by previous research among household contacts in Vietnam, but routine implementation with a different tuberculin reagent showed unexpectedly low TST positivity.OBJECTIVE: TST (5 mm and 10 mm) results were compared to QuantiFERON™-TB Gold Plus (QFT) results in household contacts during community campaigns in 2020 and 2021.DESIGN: This was a cross-sectional multi-center implementation study.RESULTS: Among 1,330 household contacts in 2020, we found a TBI prevalence of 38.6% (QFT), similar to TST 5 mm (37.4%) and higher than TST 10 mm (13.1%). QFT+/TST+ was higher for TST 5 mm (20.7%) than TST 10 mm (9.4%). QFT was not discordant with TST 5 mm (McNemar’s test = 0.6, P = 0.5) but was discordant with TST 10 mm (McNemar’s test = 263.9, P < 0.01). Older age and Southern region increased odds for positive TST 5 mm and QFT with weaker associations for TST 10 mm. Agreement and discordance were similar in 2021 for 1,158 household contacts.CONCLUSION: Tuberculin reagents affect TST positivity rates. High TB burden countries should monitor reliability of TBI diagnosis, including tuberculin potency, cold chain, and TST technique to optimize eligibility for TB preventive treatment.

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Comparison of IGRA and TST in the diagnosis of latent tuberculosis among women of reproductive age in South India

Cited by 2 publications

References 22 publications

Test and Treat Model for Tuberculosis Preventive Treatment among Household Contacts of Pulmonary Tuberculosis Patients in Selected Districts of Maharashtra: A Mixed-Methods Study on Care Cascade, Timeliness, and Early Implementation Challenges

Test and Treat Model for Tuberculosis Preventive Treatment among Household Contacts of Pulmonary Tuberculosis Patients in Selected Districts of Maharashtra: A Mixed-Methods Study on Care Cascade, Timeliness, and Early Implementation Challenges

Tuberculin skin testing and QuantiFERON™-TB Gold Plus positivity among household contacts in Vietnam

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