Exposed! Management of MDR-TB household contacts in an evidence light era

Gaskell, Katherine M; Allen, Rhiannon; Moore, David

doi:10.1016/j.ijid.2019.02.037

Cited by 1 publication

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References 12 publications

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“…Prevention of the increased incidence of MDR TB from latent TB caused by MDR strains is very important for the success of TB control programs. [6][7][8][9][10] The diagnosis of LTBI can be a challenge because there is no gold-standard check. The number of bacteria in LTBI individuals is unknown, but it is believed to be so small that it is impossible to directly examine Mtb bacteria, so an immunological examination is carried out instead.…”

Section: Introductionmentioning

confidence: 99%

Concordance of TST and QFT-Plus, Sensitivity and Specificity of TST and QFT-Plus in Detection of LTBI in MDR TB Contact

et al. 2022

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Background: Tuberculosis (TB) is an infectious disease and the main cause of world health problems. Not all individuals infected with Mycobacterium tuberculosis (Mtb) develop active TB. Latent tuberculosis infection (LTBI) is a state of persistent immune response to stimulation of the Mtb antigen with no evidence of clinically manifest active TB. Closed contact and household contact with MDR TB patients increases the risk of MDR TB transmission. There is no gold-standard test for LTBI. Tuberculin Skin Test (TST) and Quantiferon Gold Plus (QFT-Plus) examinations are used for LTBI diagnosis.Methods: A cross-sectional diagnostic test of 32 MDR TB contacts, consisting of 16 household contacts and 16 close contacts, was conducted in April 2020 at Dr. Moewardi Surakarta Hospital.Results: Positive TST results among MDR TB contacts were 18.8%, while QFT-Plus positive was 25%. The concordance level of TST and QFT-Plus was nearly perfect (κ=0.818, p<0.001). The sensitivity and specificity of QFT-Plus with household contacts as the gold standard were 37.5% and 87.5%, respectively. The sensitivity and specificity of TST with household contacts as the gold standard were 25% and 87.5%, respectively.Conclusion: The concordance level of TST and QFT-Plus in the detection of LTBI in MDR TB contacts was very good. The TST can be used in place of QFT-Plus although QFT-Plus has better sensitivity. Both tests are useful for confirming TB infections. Both of these tests are not diagnostic, however they can be used to screen for LTBI in MDR TB contacts.

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