Boddu Deepthi, Verghese Valsan Philip, Michael Joy Sarojini, Chacko Anila, Jeyaseelan Visali
Department of Paediatrics, Christian Medical College, Vellore, Tamil Nadu, India.
Department of Clinical Microbiology, Christian Medical College, Vellore, Tamil Nadu, India.
Indian J Med Microbiol. 2019 Jul-Sep;37(3):433-437. doi: 10.4103/ijmm.IJMM_19_227.
This prospective cohort study was conducted to compare the accuracy of QuantiFERON-TB (QFT) Gold In-Tube test and tuberculin skin test (TST) in diagnosing tuberculosis (TB) in predominantly bacille Calmette-Guerin-vaccinated children with a high incidence of malnutrition. The sensitivity of the QFT versus the TST was 69.6% versus 52.9% for WHO-defined TB, with specificity of 86% versus 78.3%, respectively. The concordance of the TST and QFT was 79% overall (κ = 0.430), 62.5% in those with WHO-defined TB and 85.7% in those without TB. Majority of the QFT+/TST - discordance was seen in children with TB, whereas majority of the TST+/QFT - discordance was seen in those without TB. The TST was more likely to be negative in children with moderate-to-severe malnutrition (P = 0.003) compared to the QFT, which was more likely to be positive in younger children. The significantly better performance of the QFT in malnourished children and those at younger ages supports its use for TB diagnosis in these subpopulations.
本前瞻性队列研究旨在比较结核感染T细胞检测（QFT）-金标管试验和结核菌素皮肤试验（TST）在诊断主要接种卡介苗且营养不良发生率高的儿童结核病（TB）方面的准确性。对于世界卫生组织定义的结核病，QFT相对于TST的敏感性分别为69.6%和52.9%，特异性分别为86%和78.3%。TST和QFT的总体一致性为79%（κ = 0.430），在世界卫生组织定义的结核病患者中为62.5%，在无结核病患者中为85.7%。QFT+/TST - 不一致情况大多见于结核病患儿，而TST+/QFT - 不一致情况大多见于无结核病患儿。与QFT相比，中重度营养不良儿童的TST更可能为阴性（P = 0.003），而QFT在年幼儿童中更可能为阳性。QFT在营养不良儿童和年幼儿童中的表现明显更好，支持其在这些亚人群中用于结核病诊断。
