Abstract
This study aimed at determining the sensitivity of a whole blood interferon-γ release assay (IGRA) among children with microbiologically confirmed tuberculosis in a high-burden country. Children with a diagnosis of tuberculosis based on clinical and radiographic assessment were tested with an IGRA in addition to microbiologic examination of appropriate specimens for acid-fast bacilli, mycobacterial rRNA, and observation for growth of Mycobacterium tuberculosis on appropriate culture media. Of the 405 children with a clinical diagnosis of tuberculosis, 91 (22.5 %) had microbiologically confirmed tuberculosis, of whom 81 were tested with an IGRA. A positive result was obtained in 43 (sensitivity 53.1 %, 95 % confidence interval 42.3 to 63.6 %), uninfluenced by age, sex, or disease manifestation. Conclusions: The sensitivity of a whole blood interferon-γ release assay in microbiologically confirmed pediatric tuberculosis was low. An IGRA cannot, thus, be used as rule-in test, but it might be useful to rule in tuberculosis among children in whom tuberculosis is notoriously difficult to confirm microbiologically.
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Acknowledgments
We thank the personnel at the Collaborating Institute of Infectious Diseases in Switzerland: Jasmin Portmann introduced the diagnostic technologies, assisted in building up the operation of the tuberculosis laboratory, and trained the technical staff. Annemarie Hilty was responsible for the laboratory cultures. Doris Schopfer and Simon Lüthi were in charge of the reagent production, planning and logistics of shipments, and uninterrupted supply of material and equipment. The project was funded by a grant from the University of Bern and the Kantha Bopha Foundation.
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Schopfer, K., Rieder, H.L., Bodmer, T. et al. The sensitivity of an interferon-γ release assay in microbiologically confirmed pediatric tuberculosis. Eur J Pediatr 173, 331–336 (2014). https://doi.org/10.1007/s00431-013-2161-x
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DOI: https://doi.org/10.1007/s00431-013-2161-x