Utility of the QuantiFERONW-TB Gold In-Tube assay for the diagnosis of tuberculosis in Moroccan children

SETTING: The utility of interferon-gamma release assays (IGRAs), such as the QuantiFERONw-TB Gold In-Tube (QFT-GIT) test, in diagnosing active tuberculosis (TB) in children is unclear and depends on the epidemiological setting. OBJECTIVE : To evaluate the performance of QFT-GIT for TB diagnosis in children living in Morocco, an intermediate TB incidence country with high bacille Calmette-Guérin vaccination coverage. DE S IGN: We prospectively recruited 109 Moroccan children hospitalised for clinically suspected TB, all of whom were tested using QFT-GIT. RESULT S : For 81 of the 109 children, the final diagnosis was TB. The remaining 28 children did not have TB. QFT-GIT had a sensitivity of 66% (95%CI 52-77) for the diagnosis of TB, and a specificity of 100% (95%CI 88-100). The tuberculin skin test (TST) had lower sensitivity, at 46% (95%CI 33-60), and its concordance with QFT-GITwas limited (69%). Combining QFT-GIT and TST results increased sensitivity to 83% (95%CI 69-92). CONC L U S ION: In epidemiological settings such as those found in Morocco, QFT-GIT is more sensitive than the TST for active TB diagnosis in children. Combining the TST and QFT-GIT would be useful for the diagnosis of active TB in children, in combination with clinical, radiological and laboratory data.