Evaluation of an Interferon-gamma Release Assay in Children with Suspected Tuberculosis in Papua New Guinea

Abstract

There are few data from tuberculosis (TB) endemic settings of the performance and outcome predictors of the QuantiFERON-TB Gold in Tube assay (QFT) in children with suspected TB. A prospective cross-sectional study was conducted in Papua New Guinea children with suspected TB evaluated at Port Moresby General Hospital (Port Moresby, Papua New Guinea). Two hundred sixteen children were enrolled including 106 probable TB, 87 possible TB and 23 without TB. Concordance between QFT and tuberculin skin test results was 86% (P < 0.001, κ = 0.70). QFT was significantly more likely to be positive than tuberculin skin test, overall and within the probable or possible TB categories, with no difference in prevalence of positivity between these 2 categories. The role of QFT in supporting the clinical diagnosis of TB in endemic settings, where resources are limited, remains uncertain especially as cost and technical requirements remain considerable.

Systematic review and meta-analysis on the utility of Interferon-gamma release assays for the diagnosis of Mycobacterium tuberculosis finfection in children: a 2013 update

“…For the analysis of sensitivity, 31 studies (20 conducted in high income countries and 11 in low income countries) for QFT-G-IT, including 6183 children [3,16-44], 14 studies (9 conducted in high income countries and 5 conducted in low income countries for T-SPOT.TB including 2518 children [10,14,16,18,19,22,23,37,39,45-48,50] and 34 studies (18 studies conducted in high income countries and 16 studies conducted in low income countries) for TST including 6439 children [14,17-35,37-43,45-47,49,50] were included.…”

“…The specificity analysis included 17 studies, overall including 3844 children (11 conducted in high income countries and 6 in low income countries) using QFT-G-IT [16-22,24-27,30,32,34,37,43], 9 studies overall including 1296 children (6 conducted in high income countries and 3 in low income countries) using T-SPOT.TB [16,18,19,22,23,45,46,48,49], and 17 studies overall including 3548 children (10 conducted in high income countries and 7 conducted in low income countries) using TST [17-23,25-27,30,32,34,37,45-47], as summarized in Figure 1.…”

“…Overall, 11 studies have assessed utility of IGRAs in paediatric populations including HIV infected children [3,34,43,50,52-58]. However, three of them were excluded because the used tests were the in house-ELISPOT [52,55] and the QFT-G not in-tube assay [58].…”

“…Complete data for a specific subgroup-analysis were available in four studies [3,34,43,50]. Haustein and colleagues included in their analysis immunocompromised children with several different pathologic conditions, including malignancies [3].…”

“…Haustein and colleagues included in their analysis immunocompromised children with several different pathologic conditions, including malignancies [3]. In three studies utility of QFT-G-IT was compared to TST [3,34,43], while Ling and colleagues compared T-SPOT.TB to TST [50]. …”