Accuracy of an Interferon-gamma Release Assay to Detect Active Tuberculosis in Children: A Pilot Study

Young Jin Lee; Peter Chun; Ju Hee We; Su Eun Park

doi:10.14776/kjpid.2011.18.1.48

Journal List > Korean J Pediatr Infect Dis > v.18(1) > 1096091

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Lee, Chun, We, and Park: Accuracy of an Interferon-gamma Release Assay to Detect Active Tuberculosis in Children: A Pilot Study

Original Article

Korean Journal of Pediatric Infectious Diseases

Korean Journal of Pediatric Infectious Diseases 2011; 18(1): 48-53.

Published online: 29 June 2011

DOI: https://doi.org/10.14776/kjpid.2011.18.1.48

Accuracy of an Interferon-gamma Release Assay to Detect Active Tuberculosis in Children: A Pilot Study

Young Jin Lee, M.D., Peter Chun, M.D., Ju Hee We, M.D., Su Eun Park, M.D.

Department of Pediatrics, School of Medicine, Pusan National University, Yangsan, Korea.

Correspondence: Su Eun Park, M.D. Department of Pediatrics, School of Medicine, Pusan National University, Yangsan, Korea. Tel: 055-360-2180, Fax: 055-360-2181, psepse@naver.com

Received 15 September 2010 Revised 20 October 2010 Accepted 20 October 2010

Abstract

Purpose

Early diagnosis of active tuberculosis (TB) in children is difficult. The widely used tuberculin skin test has low sensitivity and cross reactivity with non-tuberculous mycobacteria or Bacille Calmette-Guérin vaccination. Interferon gamma release assays have been shown good diagnostic accuracy for active in adults. But studies in children were limited. The purpose of this study was to examine the performance of enzyme-linked immunospot assay (ELISpot) as an initial test in the diagnosis of active tuberculosis in children.

Methods

In a hospital-based study, we prospectively examined the performance of ELISPot in 33 children suspected of active TB. TB was confirmed bacteriologically or histologically.

Results

Among 33 patients, 9 had active tuberculosis. When tested, they all had a positive test result from the ELISpot. The sensitivity and specificity of the assay were 100% (95% CI, 66.4-100%) and 95.8% (95% CI, 78.9-99.9%) respectively.

Conclusion

ELISpot might be an useful and improved clinical diagnostic method for the detection of active TB in children.

Keywords: Active tuberculosis, Interferon gamma, Children

References

1. Tuberculosis, fact sheet no. 104. World Health Organization. 2007. Geneva, Switzerland: World Health Organization;http://www.who.int/mediacentre/factsheets/fs104/en/.

2. Chan ED, Heifets L, Iseman MD. Immunologic diagnosis of tuberculosis: a review. Tuber Lung Dis. 2000. 80:131–140.

3. Keeler E, Perkins MD, Small P, Hanson C, Reed S, Cunningham J, et al. Reducing the global burden of tuberculosis: the contribution of improved diagnostics. Nature. 2006. 444:49–57.

4. Hesseling AC, Schaaf HS, Gie RP, Starke JR, Beyers N. A critical review of diagnostic approaches used in the diagnosis of childhood tuberculosis. Int J Tuberc Lung Dis. 2002. 6:1038–1045.

5. Shingadia D, Novelli V. Diagnosis and treatment of tuberculosis in children. Lancet Infect Dis. 2003. 3:624–632.

6. Pai M, Kalantri S, Dheda K. New tools and emerging technologies for the diagnosis of tuberculosis: Part I. Latent tuberculosis. Expert Rev Mol Diagn. 2006. 6:413–422.

7. Richeldi L. An update on the diagnosis of tuberculosis infection. Am J Respir Crit Care Med. 2006. 174:736–742.

8. Pai M, Dheda K, Cunningham J, Scano F, O'Brien R. T-cell assays for the diagnosis of latent tuberculosis infection: moving the research agenda forward. Lancet Infect Dis. 2007. 7:428–438.

9. Detjen AK, Keil T, Roll S, Hauer B, Mauch H, Wahn U, et al. Interferon-γ release assays improve the diagnosis of tuberculosis and nontuberculous mycobacterial disease in children in a country with a low incidence of tuberculosis. Clin Infect Dis. 2007. 45:322–328.

10. Kampmann B, Whittaker E, Williams A, Walters S, Gordon A, Martinez-Alier N, et al. Interferon-gamma release assays do not identify more children with active tuberculosis than tuberculin skin test. Eur Respir J. 2009. 33:1374–1382.

11. Pai M, Menzies D. Interferon-gamma release assays: what is their role in the diagnosis of active tuberculosis? Clin Infect Dis. 2007. 44:74–77.

12. Nishimura T, Hasegawa N, Mori M, Takebayashi T, Harada N, Higuchi K, et al. Accuracy of an interferon-gamma release assay to detect active pulmonary and extra-pulmonary tuberculosis. Int J Tuberc Lung Dis. 2008. 12:269–274.

13. Dosanjh DP, Hinks TS, Innes JA, Deeks JJ, Pasvol G, Hackforth S, et al. Improved diagnostic evaluation of suspected tuberculosis. Ann Intern Med. 2008. 148:325–336.

14. Liebeschuetz S, Bamber S, Ewer K, Deeks J, Pathan AA, Lalvani A. Diagnosis of tuberculosis in South African children with a T-cell-based assay: a prospective cohort study. Lancet. 2004. 364:2196–2203.

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