Factors associated with the performance of a blood-based interferon-γ release assay in diagnosing tuberculosis.

<h4>Background</h4>Indeterminate results are a recognised limitation of interferon-γ release assays (IGRA) in the diagnosis of latent tuberculosis (TB) infection (LTBI) and TB disease, especially in children. We investigated whether age and common co-morbidities were associated with IGRA...

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Autores principales:	Sally Banfield, Elaine Pascoe, Aesen Thambiran, Aris Siafarikas, David Burgner
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2012
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/2e7a0496959b4b4f8c6f4bbeedd3f116
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spelling	oai:doaj.org-article:2e7a0496959b4b4f8c6f4bbeedd3f1162021-11-18T07:15:46ZFactors associated with the performance of a blood-based interferon-γ release assay in diagnosing tuberculosis.1932-620310.1371/journal.pone.0038556https://doaj.org/article/2e7a0496959b4b4f8c6f4bbeedd3f1162012-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/22701664/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Background</h4>Indeterminate results are a recognised limitation of interferon-γ release assays (IGRA) in the diagnosis of latent tuberculosis (TB) infection (LTBI) and TB disease, especially in children. We investigated whether age and common co-morbidities were associated with IGRA performance in an unselected cohort of resettled refugees.<h4>Methods</h4>A retrospective cross-sectional study of refugees presenting for their post-resettlement health assessment during 2006 and 2007. Refugees were investigated for prevalent infectious diseases, including TB, and for common nutritional deficiencies and haematological abnormalities as part of standard clinical screening protocols. Tuberculosis screening was performed by IGRA; QuantiFERON-TB Gold in 2006 and QuantiFERON-TBGold In-Tube in 2007.<h4>Results</h4>Complete data were available on 1130 refugees, of whom 573 (51%) were children less than 17 years and 1041 (92%) were from sub-Saharan Africa. All individuals were HIV negative. A definitive IGRA result was obtained in 1004 (89%) refugees, 264 (26%) of which were positive; 256 (97%) had LTBI and 8 (3%) had TB disease. An indeterminate IGRA result was obtained in 126 (11%) refugees (all failed positive mitogen control). In multivariate analysis, younger age (linear OR= 0.93 [95% CI 0.91-0.95], P<0.001), iron deficiency anaemia (2.69 [1.51-4.80], P = 0.001), malaria infection (3.04 [1.51-6.09], P = 0.002), and helminth infection (2.26 [1.48-3.46], P<0.001), but not vitamin D deficiency or insufficiency, were associated with an indeterminate IGRA result.<h4>Conclusions</h4>Younger age and a number of common co-morbidities are significantly and independently associated with indeterminate IGRA results in resettled predominantly African refugees.Sally BanfieldElaine PascoeAesen ThambiranAris SiafarikasDavid BurgnerPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 7, Iss 6, p e38556 (2012)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Sally Banfield Elaine Pascoe Aesen Thambiran Aris Siafarikas David Burgner Factors associated with the performance of a blood-based interferon-γ release assay in diagnosing tuberculosis.
description	<h4>Background</h4>Indeterminate results are a recognised limitation of interferon-γ release assays (IGRA) in the diagnosis of latent tuberculosis (TB) infection (LTBI) and TB disease, especially in children. We investigated whether age and common co-morbidities were associated with IGRA performance in an unselected cohort of resettled refugees.<h4>Methods</h4>A retrospective cross-sectional study of refugees presenting for their post-resettlement health assessment during 2006 and 2007. Refugees were investigated for prevalent infectious diseases, including TB, and for common nutritional deficiencies and haematological abnormalities as part of standard clinical screening protocols. Tuberculosis screening was performed by IGRA; QuantiFERON-TB Gold in 2006 and QuantiFERON-TBGold In-Tube in 2007.<h4>Results</h4>Complete data were available on 1130 refugees, of whom 573 (51%) were children less than 17 years and 1041 (92%) were from sub-Saharan Africa. All individuals were HIV negative. A definitive IGRA result was obtained in 1004 (89%) refugees, 264 (26%) of which were positive; 256 (97%) had LTBI and 8 (3%) had TB disease. An indeterminate IGRA result was obtained in 126 (11%) refugees (all failed positive mitogen control). In multivariate analysis, younger age (linear OR= 0.93 [95% CI 0.91-0.95], P<0.001), iron deficiency anaemia (2.69 [1.51-4.80], P = 0.001), malaria infection (3.04 [1.51-6.09], P = 0.002), and helminth infection (2.26 [1.48-3.46], P<0.001), but not vitamin D deficiency or insufficiency, were associated with an indeterminate IGRA result.<h4>Conclusions</h4>Younger age and a number of common co-morbidities are significantly and independently associated with indeterminate IGRA results in resettled predominantly African refugees.
format	article
author	Sally Banfield Elaine Pascoe Aesen Thambiran Aris Siafarikas David Burgner
author_facet	Sally Banfield Elaine Pascoe Aesen Thambiran Aris Siafarikas David Burgner
author_sort	Sally Banfield
title	Factors associated with the performance of a blood-based interferon-γ release assay in diagnosing tuberculosis.
title_short	Factors associated with the performance of a blood-based interferon-γ release assay in diagnosing tuberculosis.
title_full	Factors associated with the performance of a blood-based interferon-γ release assay in diagnosing tuberculosis.
title_fullStr	Factors associated with the performance of a blood-based interferon-γ release assay in diagnosing tuberculosis.
title_full_unstemmed	Factors associated with the performance of a blood-based interferon-γ release assay in diagnosing tuberculosis.
title_sort	factors associated with the performance of a blood-based interferon-γ release assay in diagnosing tuberculosis.
publisher	Public Library of Science (PLoS)
publishDate	2012
url	https://doaj.org/article/2e7a0496959b4b4f8c6f4bbeedd3f116
work_keys_str_mv	AT sallybanfield factorsassociatedwiththeperformanceofabloodbasedinterferongreleaseassayindiagnosingtuberculosis AT elainepascoe factorsassociatedwiththeperformanceofabloodbasedinterferongreleaseassayindiagnosingtuberculosis AT aesenthambiran factorsassociatedwiththeperformanceofabloodbasedinterferongreleaseassayindiagnosingtuberculosis AT arissiafarikas factorsassociatedwiththeperformanceofabloodbasedinterferongreleaseassayindiagnosingtuberculosis AT davidburgner factorsassociatedwiththeperformanceofabloodbasedinterferongreleaseassayindiagnosingtuberculosis
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Factors associated with the performance of a blood-based interferon-γ release assay in diagnosing tuberculosis.

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