Emerg Infect Dis. 2020 Aug;26(8):1686-94. doi: 10.3201/eid2608.190793.
US guidelines have recommended testing children emigrating from high tuberculosis-incidence countries with interferon-gamma release assays (IGRAs) or tuberculin skin tests (TSTs). We describe the Harris County (Texas) Public Health Refugee Health Screening Program's testing results during 2010-2015 for children <18 years of age: 5,990 were evaluated, and 5,870 (98%) were tested. Overall, 364 (6.2%) children had >1 positive test: 143/1,842 (7.8%) were tested with TST alone, 129/3,730 (3.5%) with IGRA alone, and 92/298 (30.9%) with both TST and IGRA. Region of origin and younger age were associated with positive TST or IGRA results. All children were more likely to have positive results for TST than for IGRA (OR 2.92, 95% CI 2.37-3.59). Discordant test results were common (20%) and most often were TST+/IGRA- (95.0%), likely because of bacillus Calmette-Guérin vaccination. Finding fewer false positives supports the 2018 change in US immigration guidelines that recommends using IGRAs for recently immigrated children.
美国指南建议对来自高结核发病率国家的移民儿童使用干扰素-γ释放试验（IGRAs）或结核菌素皮肤试验（TSTs）进行检测。我们描述了 2010 年至 2015 年哈里斯县（德克萨斯州）公共卫生难民健康筛查计划对<18 岁儿童的检测结果：共评估了 5990 名儿童，其中 5870 名（98%）接受了检测。总体而言，364 名（6.2%）儿童有>1 项阳性检测结果：143/1842 名（7.8%）仅接受 TST 检测，129/3730 名（3.5%）仅接受 IGRAs 检测，92/298 名（30.9%）同时接受 TST 和 IGRAs 检测。原籍地区和年龄较小与 TST 或 IGRAs 阳性结果相关。所有儿童 TST 阳性结果的可能性均高于 IGRA（OR 2.92，95%CI 2.37-3.59）。检测结果不一致很常见（20%），且最常见的是 TST+/IGRA-（95.0%），这可能是由于卡介苗接种所致。假阳性结果较少，这支持了美国移民指南 2018 年的改变，该指南建议对最近移民的儿童使用 IGRAs。
