ArticleThe Pediatric infectious disease journal2013
Detecting tuberculosis infection in HIV-infected children: a study of diagnostic accuracy, confounding and interaction.
Article in The Pediatric infectious disease journal, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 4 of them syntheses that pooled it.
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Who cites it
22 citing papers in PubMed, 4 syntheses or guidelines pooled it, 46 citations in OpenAlex.
- Is interleukin-2 an optimal marker for diagnosing tuberculosis infection? A systematic review and meta-analysis.Annals of medicine · 2020Pooled it
- Risk Factors for Indeterminate Interferon-Gamma Release Assay for the Diagnosis of Tuberculosis in Children-A Systematic Review and Meta-Analysis.Frontiers in pediatrics · 2019Pooled it
- Recommendations for the diagnosis of pediatric tuberculosis.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2016Guideline
- Systematic review and meta-analysis on the utility of Interferon-gamma release assays for the diagnosis of Mycobacterium tuberculosis infection in children: a 2013 update.BMC infectious diseases · 2014Pooled it
- Tuberculin skin test surveys and the Annual Risk of Tuberculous Infection in school children in Northern KwaZulu-Natal.PLOS global public health · 2024Article
- Clinical relevance of false-negative interferon-gamma release assays in patients with tuberculous pleurisy in an intermediate tuberculosis burden country.Journal of thoracic disease · 2022Article
- Tuberculosis in children with severe acute malnutrition.Expert review of respiratory medicine · 2022Review
- Infant TB Infection Prevention Study (iTIPS): a randomised trial protocol evaluating isoniazid to preventBMJ open · 2020Article
- Article
- T-SPOT.TB Performance in Routine Pediatric Practice in a Low TB Burden Setting.The Pediatric infectious disease journal · 2018Article
- Usefulness of interferon-γ release assay for the diagnosis of sputum smear-negative pulmonary and extra-pulmonary TB in Zhejiang Province, China.Infectious diseases of poverty · 2017Article
- Tuberculosis in Infants and Children.Microbiology spectrum · 2017Review
- Pediatric tuberculosis-human immunodeficiency virus co-infection in the United Kingdom highlights the need for better therapy monitoring tools: a case report.Journal of medical case reports · 2017Article
- Clinical Application of Interferon-γ Release Assays for the Prevention of Tuberculosis in Countries with Low Incidence.Pathogens & immunity · 2016Article
- Optimizing the detection of recent tuberculosis infection in children in a high tuberculosis-HIV burden setting.American journal of respiratory and critical care medicine · 2015Article
- Breathprints of model murine bacterial lung infections are linked with immune response.The European respiratory journal · 2015Article
- Quantiferon Gold-in-tube assay for TB screening in HIV infected children: influence of quantitative values.BMC infectious diseases · 2014Article
- Childhood tuberculosis: a concern of the modern world.European respiratory review : an official journal of the European Respiratory Society · 2014Review
- Tuberculosis and HIV co-infection in children.BMC infectious diseases · 2014Review
- Comparing interferon-gamma release assays to tuberculin skin test in Thai children with tuberculosis exposure.PloS one · 2014Article
Corrections and comments
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Authors and funding
10 authors at 5 institutions in 4 countries.
Funding
Abstract
backgroundAccurate identification of Mycobacterium tuberculosis infection in young and HIV-infected children could guide delivery of preventive therapy, improve resource utilization and help prevent tuberculosis.
methodsWe assessed the performance of the tuberculin skin test (TST) and interferon-γ release assays (IGRAs) for identifying M. tuberculosis infection in South African children presenting for outpatient care. Tuberculosis contact was quantified using a standardized measure of M. tuberculosis exposure. Logistic regression assessed the association among test positivity, age, nutritional and HIV status, while controlling for M. tuberculosis exposure, bacille Calmette-Guérin vaccination and prior tuberculosis treatment.
resultsAmong 250 (130 HIV infected) children (age 0.25-14.6 years, median 39 months), the proportion positive for each test varied: 34% (TST), 21% (T-SPOT.TB) and 25% (QuantiFERON-TB Gold In-Tube). IGRAs were more likely to be positive in HIV-uninfected compared with HIV-infected children; TST positivity did not differ between these groups. Agreement between tests was good-to-excellent in HIV-uninfected children and poor-to-good in HIV-infected children. In adjusted models, TST and T-SPOT.TB were positively associated with age; this effect varied by HIV status. The QuantiFERON-TB Gold In-Tube was negatively associated with chronic malnutrition; this effect varied by HIV status. Because 93% of children had received bacille Calmette-Guérin, we could not assess the contribution of bacille Calmette-Guérin to false-positive TST results.
conclusionsOur findings indicate that the TST and IGRAs perform similarly for the detection of M. tuberculosis infection in well-nourished HIV-uninfected children, but test performance is differentially affected by chronic malnutrition, HIV infection and age. Similar to TST interpretation, clinicians and researchers should interpret IGRAs in children with caution taking age, nutritional and HIV status into consideration.
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