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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Comparison of T-SPOT. TB assay and tuberculin skin test for the evaluation of young children at high risk for tuberculosis in a community setting
Pediatrics, Volume 123, No. 1, Year 2009
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Description
OBJECTIVE. We wished to compare the sensitivity of an enzyme-linked immunospot assay (T-SPOT.TB; Oxford Immunotec, Oxford, United Kingdom) and the tuberculin skin test for the detection of tuberculosis infection in very young children being evaluated for active tuberculosis in a rural community setting. METHODS. Children with a history of exposure to tuberculosis and children presenting to a local clinic or hospital with symptoms suggesting tuberculosis were admitted to a dedicated case verification ward. T-SPOT. TB testing was performed, and children were evaluated with a clinical examination, a tuberculin skin test, chest radiographs, and cultures of induced sputum and gastric lavage specimens. The diagnosis was determined by using a clinical algorithm. RESULTS. A total of 243 children (median age: 18 months) were recruited, of whom 214 (88%) had interpretable T-SPOT.TB results. Children ≥12 months of age were more likely than younger children to have positive T-SPOT. TB results, whereas tuberculin skin test results were unaffected by age. The sensitivity of the T-SPOT. TB was no better than that of the tuberculin skin test for culture-confirmed tuberculosis (50% and 80%, respectively) and was poorer for the combined group of culture-confirmed and clinically probable tuberculosis (40% and 52%, respectively). For the 50 children clinically categorized as not having tuberculosis, the specificity of both the T-SPOT.TB and the tuberculin skin test was 84%. CONCLUSIONS. For young children presenting in a community setting after exposure to tuberculosis or with symptoms suggesting tuberculosis, T-SPOT. TB cannot be used to exclude active disease. The sensitivity of this assay may be impaired for very young children. Copyright © 2009 by the American Academy of Pediatrics.
Authors & Co-Authors
Nicol, Mark P.
South Africa, Cape Town
School of Child and Adolescent Health
South Africa, Cape Town
University of Cape Town
South Africa, Observatory
South African Tuberculosis Vaccine Initiative
South Africa, Cape Town
Faculty of Health Sciences
Davies, M. A.
South Africa, Cape Town
School of Child and Adolescent Health
South Africa, Cape Town
School of Public Health and Family Medicine
Wood, Kathryn
South Africa, Cape Town
School of Child and Adolescent Health
Hatherill, Mark
South Africa, Cape Town
School of Child and Adolescent Health
South Africa, Observatory
South African Tuberculosis Vaccine Initiative
Workman, Lesley J.
South Africa, Cape Town
School of Child and Adolescent Health
South Africa, Observatory
South African Tuberculosis Vaccine Initiative
Hawkridge, Anthony J.
South Africa, Cape Town
School of Child and Adolescent Health
South Africa, Observatory
South African Tuberculosis Vaccine Initiative
Eley, Brian S.
South Africa, Cape Town
School of Child and Adolescent Health
Andrea Wilkinson, Katalin Andrea
South Africa, Cape Town
University of Cape Town
United Kingdom, London
Mrc National Institute for Medical Research
Wilkinson, Robert J.
South Africa, Cape Town
University of Cape Town
United Kingdom, London
Mrc National Institute for Medical Research
United Kingdom, London
Imperial College London
Hanekom, Willem Albert
South Africa, Cape Town
School of Child and Adolescent Health
South Africa, Cape Town
University of Cape Town
South Africa, Observatory
South African Tuberculosis Vaccine Initiative
Beatty, David W.
South Africa, Cape Town
School of Child and Adolescent Health
Hussey, Greg Dudley
South Africa, Cape Town
School of Child and Adolescent Health
South Africa, Cape Town
University of Cape Town
South Africa, Observatory
South African Tuberculosis Vaccine Initiative
Statistics
Citations: 129
Authors: 12
Affiliations: 7
Identifiers
Doi:
10.1542/peds.2008-0611
ISSN:
00314005
e-ISSN:
10984275
Research Areas
Health System And Policy
Infectious Diseases
Maternal And Child Health