TY - JOUR
T1 - Utility of the interferon-gamma release assay for latent tuberculosis infection screening among Indian health-care workers
AU - Girish, Sunita
AU - Kinikar, Aarti
AU - Pardeshi, Geeta
AU - Shelke, Sangita
AU - Basavaraj, Anita
AU - Chandanwale, Ajay
AU - Kadam, Dileep
AU - Joshi, Samir
AU - Dhumal, Gauri
AU - Lokhande, Nilima
AU - Deluca, Andrea
AU - Gupte, Nikhil
AU - Gupta, Amita
AU - Bollinger, Robert C.
AU - Mave, Vidya
N1 - Funding Information:
This study was supported by the National Institute of Health (NIH) Supplement for BWI Clinical Trials Unit for NIAID Networks (UM1) (P.I. Flexner/Gupta, UM01AI069465) and the BJGMC JHU HIV TB Program funded by the Fogarty International Center, NIH) (grant # D43TW009574). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. The authors also acknowledge support from Persistent Systems in kind.
Publisher Copyright:
© 2021 Indian Journal of Community Medicine | Published by Wolters Kluwer - Medknow
PY - 2021/4/1
Y1 - 2021/4/1
N2 - Background: The utility of interferon-gamma release assays (IGRAs) for latent tuberculosis infection (LTBI) screening among health-care workers (HCWs) in low- and middle-income countries (LMICs) remains unclear. Methods: This was a prospective cohort study among HCW trainees undergoing annual LTBI screening via tuberculin skin test (TST) and QuantiFERON® TB Gold Test-in-tube (QFT-GIT) in Pune, India. TST induration ≥ 10 mm and QFT-GIT ≥ 0.35 IU/ml were considered positive. Test concordance was evaluated at entry among the entire cohort and at 1 year among baseline TST-negative participants with follow-up testing. Overall test agreement was evaluated at both timepoints using the kappa statistic: fair (k < 0.40), good (0.41 ≥ k ≤0.60), or strong (k > 0.60). Results: Of 200 participants, prevalent LTBI was detected in 42 (21%) via TST and 45 (23%) via QFT-GIT; QFT-GIT was positive in 27/42 (64%) TST-positive and 18/158 (11%) TST-negative trainees. Annual TST conversion was 28% (40/142) and included 11 trainees with baseline TST-/IGRA+; QFT-GIT was positive in 17/40 (43%) TST-positive and 5/102 (5%) TST-negative trainees. Overall test concordance was 84% (k = 0.52; 95% confidence interval [CI]: 0.38–0.66) and 80% (k = 0.44; 95% CI: 0.29–0.59) at baseline and 12 months, respectively. Conclusions: We observed good overall agreement between TST and QFT-GIT, and QFT-GIT detected additional LTBI cases among TST-negative trainees with possible early detection of LTBI conversion. Overall, our results support the use of IGRA for annual LTBI screening among HCWs in a high burden LMIC setting.
AB - Background: The utility of interferon-gamma release assays (IGRAs) for latent tuberculosis infection (LTBI) screening among health-care workers (HCWs) in low- and middle-income countries (LMICs) remains unclear. Methods: This was a prospective cohort study among HCW trainees undergoing annual LTBI screening via tuberculin skin test (TST) and QuantiFERON® TB Gold Test-in-tube (QFT-GIT) in Pune, India. TST induration ≥ 10 mm and QFT-GIT ≥ 0.35 IU/ml were considered positive. Test concordance was evaluated at entry among the entire cohort and at 1 year among baseline TST-negative participants with follow-up testing. Overall test agreement was evaluated at both timepoints using the kappa statistic: fair (k < 0.40), good (0.41 ≥ k ≤0.60), or strong (k > 0.60). Results: Of 200 participants, prevalent LTBI was detected in 42 (21%) via TST and 45 (23%) via QFT-GIT; QFT-GIT was positive in 27/42 (64%) TST-positive and 18/158 (11%) TST-negative trainees. Annual TST conversion was 28% (40/142) and included 11 trainees with baseline TST-/IGRA+; QFT-GIT was positive in 17/40 (43%) TST-positive and 5/102 (5%) TST-negative trainees. Overall test concordance was 84% (k = 0.52; 95% confidence interval [CI]: 0.38–0.66) and 80% (k = 0.44; 95% CI: 0.29–0.59) at baseline and 12 months, respectively. Conclusions: We observed good overall agreement between TST and QFT-GIT, and QFT-GIT detected additional LTBI cases among TST-negative trainees with possible early detection of LTBI conversion. Overall, our results support the use of IGRA for annual LTBI screening among HCWs in a high burden LMIC setting.
KW - Concordant and discordant test results
KW - Health-care workers
KW - Latent tuberculosis infection
KW - Quanti FERON® TB Gold Test-in-tube (QFT-GIT)
KW - Tuberculin skin test
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U2 - 10.4103/ijcm.IJCM_761_20
DO - 10.4103/ijcm.IJCM_761_20
M3 - Article
C2 - 34321742
AN - SCOPUS:85107613456
SN - 0970-0218
VL - 46
SP - 281
EP - 284
JO - Indian Journal of Community Medicine
JF - Indian Journal of Community Medicine
IS - 2
ER -