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加纳阿克拉确诊肺结核患者的密切家庭接触者中,全血γ-干扰素释放试验检测潜伏性结核感染的效用。

Utility of QuantiFERON tuberculosis gold-in-tube test for detecting latent tuberculosis infection among close household contacts of confirmed tuberculosis patients in Accra, Ghana.

作者信息

Mensah Gloria Ivy, Sowah Sandra Akoley, Yeboah Nana Yaw Asare, Addo Kennedy Kwasi, Jackson-Sillah Dolly

机构信息

Department of Bacteriology, Noguchi Memorial Institute for Medical Research, University of Ghana, Ghana, UK.

Department of Biochemistry, Cell and Molecular Biology, University of Ghana, Accra, Ghana, UK.

出版信息

Int J Mycobacteriol. 2017 Jan-Mar;6(1):27-33. doi: 10.4103/2212-5531.201891.

Abstract

OBJECTIVE/BACKGROUND: Introduction of the interferon gamma (IFN-γ) release assays with their higher sensitivity and specificity over the traditional tuberculin skin test has improved testing for latent tuberculosis infection (LTBI). None of the IFN-γ release assays has ever been used to screen for LTBI in Ghana. This study set out to determine the utility of the QuantiFERON TB Gold-in-Tube (QFT-GIT) test for the diagnosis of LTBI among close household contacts of newly diagnosed sputum smear-positive tuberculosis (TB) patents in Accra, Ghana, and the associated risk factors for a positive QFT-GIT test.

MATERIALS AND METHODS

Close household contacts of newly diagnosed sputum smear-positive patients receiving anti-TB therapy from three hospitals in Accra were recruited, after providing written informed consent, between April 2012 and December 2014. In addition to demographic details, 2 mL of blood was collected from all participants for the QFT-GIT test for LTBI diagnosis.

RESULTS

Out of 112 eligible consenting participants, the QFT-GIT test was performed for 100 participants. The prevalence of LTBI (QFT-GIT positive) was 65%, with 32% being QFT-GIT negative and 3% indeterminate results. Contacts aged >15 years were more likely to be QFT-GIT positive than those aged >15 years, regardless of their Bacillus Calmette-Guerin status. There was significantly higher QFT-GIT test positivity in adult contacts who were parents, siblings, or spouses to index cases than in child contacts (P = 0.0016, P = 0.04, and P = 0.0003, respectively).

CONCLUSION

The QFT-GIT test will be a useful tool for screening of TB contacts for LTBI in Ghana.

摘要

目的/背景:相较于传统结核菌素皮肤试验,γ干扰素(IFN-γ)释放试验具有更高的敏感性和特异性,这改进了潜伏性结核感染(LTBI)的检测。在加纳,尚无任何一种IFN-γ释放试验用于筛查LTBI。本研究旨在确定管内QuantiFERON结核菌素金标试验(QFT-GIT)在加纳阿克拉新诊断痰涂片阳性肺结核(TB)患者的密切家庭接触者中诊断LTBI的效用,以及QFT-GIT试验阳性的相关危险因素。

材料与方法

2012年4月至2014年12月期间,在获得书面知情同意后,招募了来自阿克拉三家医院正在接受抗结核治疗的新诊断痰涂片阳性患者的密切家庭接触者。除人口统计学细节外,还从所有参与者采集了2 mL血液用于QFT-GIT试验以诊断LTBI。

结果

在112名符合条件并同意参与的参与者中,对100名参与者进行了QFT-GIT试验。LTBI(QFT-GIT阳性)的患病率为65%,32%为QFT-GIT阴性,3%为不确定结果。无论卡介苗接种状态如何,年龄>15岁的接触者比年龄≤15岁的接触者更有可能QFT-GIT阳性。与儿童接触者相比,作为索引病例的父母、兄弟姐妹或配偶的成年接触者的QFT-GIT试验阳性率显著更高(分别为P = 0.0016、P = 0.04和P = 0.0003)。

结论

QFT-GIT试验将成为加纳筛查TB接触者LTBI的有用工具。

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