Journal List > Tuberc Respir Dis > v.68(3) > 1001481

Bae, Kim, and Wang: An Usefulness of In Vitro Interferon Gamma Assay for the Diagnosis of Latent Tuberculosis Infection in Middle- and High-School Students in Jeju-Shi, Korea

Abstract

Background

The tuberculin skin test (TST) has limitations in diagnosing a latent tuberculosis infection (LTBI). The interferon-gamma release assay (IGRA) was introduced to middle- and high-school students since 2009 by the Korea Centers for Disease Control and Prevention. The aim was to evaluate the utility of IGRA in diagnosing LTBI in middle- and high-school students.

Methods

From August 2007 to July 2009, among suspected LTBI students showing TST induration with a 10 mm diameter and over with a normal chest x-ray in school students of Jeju city, 341 students underwent a Quanti FERON-TB Gold In-Tube (QFT-IT) test to confirm LTBI.

Results

From 348 students showing a positive TST, a QFT-IT test was carried out on 341 students. The positive QFT-IT rate was 52.8% (=180/341). The positive QFT-IT rate was higher in high-school boys with a 15~19 mm diameter of induration in TST.

Conclusion

With the introduction of IGRA for diagnosing LTBI in middle- and high-school students, approximately 47% of students who show a TST induration with a 10 mm diameter and over can avoid taking unnecessary preventive chemotherapy. These results suggest that IGRA is useful for diagnosing and controlling LTBI in Korean students.

Figures and Tables

Figure 1
The guideline for diagnosis of latent tuberculosis infection in school students, Korea. BCG: bacilli Chalmette-Guerin vaccine; TST: tuberculin skin test; IGRA: Interferon gamma release assay) [cited from Reference 2].
trd-68-155-g001
Table 1
Proportional rate of postive tuberculin skin test (TST) and in vitro interferon-gamma assay (QFT-IT) in subjects by events of outbreaks
trd-68-155-i001

LTBI: latent tuberculosis infection; CI: confidence interval.

Table 2
The proportional rate of positive tuberculin skin test (TST) and in vitro interferon-gamma assay (QFT-IT) in subjects in 3 high schools
trd-68-155-i002

LTBI: latent tuberculosis infection; CI: confidence interval.

Table 3
Characteristics of subjects (n=341) in positive tuberculin skin test (TST) by results of in vitro interferon-gamma assay (QFT-IT)
trd-68-155-i003

PTB: pulmonary tuberculosis infection; BCG: bacilli Chalmette-Guerin vaccine.

*p-value by chi-square test.

Table 4
Adjusted odds ratios (aOR) in results of in vitro interferon-gamma assay (QFT-IT) for age, sex and size of induration
trd-68-155-i004

CI: confidence interval.

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