Browse > Article

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

Lee, Young Jin (Department of Pediatrics, School of Medicine, Pusan National University)
Chun, Peter (Department of Pediatrics, School of Medicine, Pusan National University)
We, Ju Hee (Department of Pediatrics, School of Medicine, Pusan National University)
Park, Su Eun (Department of Pediatrics, School of Medicine, Pusan National University)
Publication Information
Pediatric Infection and Vaccine / v.18, no.1, 2011 , pp. 48-53 More about this Journal
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-Gu$\acute{e}$rin 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;
Citations & Related Records
연도 인용수 순위
  • Reference
1 World Health Organization. 2007. Tuberculosis, fact sheet no. 104. World Health Organization, Geneva, Switzerland. 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;80:131-40.   DOI   ScienceOn
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;6:1038-45.
5 Shingadia D, Novelli V. Diagnosis and treatment of tuberculosis in children. Lancet Infect Dis 2003;3:624-32.   DOI   ScienceOn
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;6:413-22.   DOI   ScienceOn
7 Richeldi L. An update on the diagnosis of tuberculosis infection. Am J Respir Crit Care Med 2006;174:736-42.   DOI   ScienceOn
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;7:428-38.   DOI   ScienceOn
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 Infec Dis 2007;45:322-8.   DOI   ScienceOn
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;33:1374-82.   DOI   ScienceOn
11 Pai M, Menzies D. Interferon-gamma release assays: what is their role in the diagnosis of active tuberculosis? Clin Infect Dis 2007;44:74-7.   DOI   ScienceOn
12 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; 364:2196-203.   DOI   ScienceOn
13 Nishimura T, Hasegawa N. Mori M, Takebayashi T, Harada N, Higuchi K et al. Accuracy of an interferongamma release assay to detect active pulmonary and extra-pulmonary tuberculosis. Int J Tuberc Lung Dis 2008;12:269-74.
14 Dosanjh DP, Hinks TS, Innes JA, Deeks JJ, Pasvol G, Hackforth S et al. Improved diagnostic evaluation of suspected tuberculosis. Ann Intern Med 2008;148:325-36.   DOI   ScienceOn