Prevalence and Diagnosis of Latent Tuberculosis Infection in Young Children in the Absence of a Gold Standard

Introduction For adequate disease control the World Health Organization has proposed the diagnosis and treatment of latent tuberculous infection (LTBI) in groups of risk of developing the disease such as children. There is no gold standard (GS) test for the diagnosis of LTBI. The objective of this s...

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Autores: Pérez-Porcuna, Tomàs M., Pereira da Silva, Hélio Doyle, Ascaso Terrén, Carlos, Malheiro, Adriana, Bührer-Sékula, Samira, 1955-, Martínez Espinosa, Flor E., Abellana Sangrà, Rosa Mari
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2016
País:España
Institución:Universidad de Barcelona
Repositorio:Dipòsit Digital de la UB
OAI Identifier:oai:diposit.ub.edu:2445/113707
Acceso en línea:https://hdl.handle.net/2445/113707
Access Level:acceso abierto
Palabra clave:Tuberculosi
Pediatria
Tuberculosis
Pediatrics
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spelling Prevalence and Diagnosis of Latent Tuberculosis Infection in Young Children in the Absence of a Gold StandardPérez-Porcuna, Tomàs M.Pereira da Silva, Hélio DoyleAscaso Terrén, CarlosMalheiro, AdrianaBührer-Sékula, Samira, 1955-Martínez Espinosa, Flor E.Abellana Sangrà, Rosa MariTuberculosiPediatriaTuberculosisPediatricsIntroduction For adequate disease control the World Health Organization has proposed the diagnosis and treatment of latent tuberculous infection (LTBI) in groups of risk of developing the disease such as children. There is no gold standard (GS) test for the diagnosis of LTBI. The objective of this study was to estimate the prevalence of LTBI in young children in contact with a household case of tuberculosis (TB-HCC) and determine the accuracy and precision of the Tuberculin Skin Test (TST) and QuantiFERON-TB Gold in-tube (QFT) used in the absence of a GS. Methods We conducted a cross-sectional study in children up to 6 years of age in Manaus/Brazil during the years 2009-2010. All the children had been vaccinated with the BCG and were classified into two groups according to the presence of a TB-HCC or no known contact with tuberculosis (TB). The variables studied were: the TST and QFT results and the intensity and length of exposure to the index tuberculosis case. We used the latent class model to determine the prevalence of LTBI and the accuracy of the tests. Results Fifty percent of the children with TB-HCC had LTBI, with the prevalence depending on the intensity and length of exposure to the index case. The sensitivity and specificity of TST were 73% [95% confidence interval (CI): 53-91] and 97% (95%CI: 89-100), respectively, versus 53% (95%CI: 41-66) and 81% (95%CI:71-90) for QFT. The positive predictive value of TST in children with TB-HCC was 91% (95%CI: 61-99), being 74% for QFT (95%CI: 47-95). Conclusions This is one of the first studies to estimate the prevalence of LTBI in children and the parameters of the main diagnostic tests using a latent class model. Our results suggest that children in contact with an index case have a high risk of infection. The accuracy and the predictive value of the two tests did not significantly differ. Combined use of the two tests showed scarce improvement in the diagnosis of LTBI.Public Library of Science (PLoS)2016info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfhttps://hdl.handle.net/2445/113707Articles publicats en revistes (Fonaments Clínics)reponame:Dipòsit Digital de la UBinstname:Universidad de BarcelonaInglésReproducció del document publicat a: https://doi.org/10.1371/journal.pone.0164181PLoS One, 2016, vol. 11, num. 10, p. e0164181https://doi.org/10.1371/journal.pone.0164181cc-by (c) Pérez-Porcuna, Tomàs M. et al., 2016http://creativecommons.org/licenses/by/3.0/esinfo:eu-repo/semantics/openAccessoai:diposit.ub.edu:2445/1137072026-05-27T06:46:51Z
dc.title.none.fl_str_mv Prevalence and Diagnosis of Latent Tuberculosis Infection in Young Children in the Absence of a Gold Standard
title Prevalence and Diagnosis of Latent Tuberculosis Infection in Young Children in the Absence of a Gold Standard
spellingShingle Prevalence and Diagnosis of Latent Tuberculosis Infection in Young Children in the Absence of a Gold Standard
Pérez-Porcuna, Tomàs M.
Tuberculosi
Pediatria
Tuberculosis
Pediatrics
title_short Prevalence and Diagnosis of Latent Tuberculosis Infection in Young Children in the Absence of a Gold Standard
title_full Prevalence and Diagnosis of Latent Tuberculosis Infection in Young Children in the Absence of a Gold Standard
title_fullStr Prevalence and Diagnosis of Latent Tuberculosis Infection in Young Children in the Absence of a Gold Standard
title_full_unstemmed Prevalence and Diagnosis of Latent Tuberculosis Infection in Young Children in the Absence of a Gold Standard
title_sort Prevalence and Diagnosis of Latent Tuberculosis Infection in Young Children in the Absence of a Gold Standard
dc.creator.none.fl_str_mv Pérez-Porcuna, Tomàs M.
Pereira da Silva, Hélio Doyle
Ascaso Terrén, Carlos
Malheiro, Adriana
Bührer-Sékula, Samira, 1955-
Martínez Espinosa, Flor E.
Abellana Sangrà, Rosa Mari
author Pérez-Porcuna, Tomàs M.
author_facet Pérez-Porcuna, Tomàs M.
Pereira da Silva, Hélio Doyle
Ascaso Terrén, Carlos
Malheiro, Adriana
Bührer-Sékula, Samira, 1955-
Martínez Espinosa, Flor E.
Abellana Sangrà, Rosa Mari
author_role author
author2 Pereira da Silva, Hélio Doyle
Ascaso Terrén, Carlos
Malheiro, Adriana
Bührer-Sékula, Samira, 1955-
Martínez Espinosa, Flor E.
Abellana Sangrà, Rosa Mari
author2_role author
author
author
author
author
author
dc.subject.none.fl_str_mv Tuberculosi
Pediatria
Tuberculosis
Pediatrics
topic Tuberculosi
Pediatria
Tuberculosis
Pediatrics
description Introduction For adequate disease control the World Health Organization has proposed the diagnosis and treatment of latent tuberculous infection (LTBI) in groups of risk of developing the disease such as children. There is no gold standard (GS) test for the diagnosis of LTBI. The objective of this study was to estimate the prevalence of LTBI in young children in contact with a household case of tuberculosis (TB-HCC) and determine the accuracy and precision of the Tuberculin Skin Test (TST) and QuantiFERON-TB Gold in-tube (QFT) used in the absence of a GS. Methods We conducted a cross-sectional study in children up to 6 years of age in Manaus/Brazil during the years 2009-2010. All the children had been vaccinated with the BCG and were classified into two groups according to the presence of a TB-HCC or no known contact with tuberculosis (TB). The variables studied were: the TST and QFT results and the intensity and length of exposure to the index tuberculosis case. We used the latent class model to determine the prevalence of LTBI and the accuracy of the tests. Results Fifty percent of the children with TB-HCC had LTBI, with the prevalence depending on the intensity and length of exposure to the index case. The sensitivity and specificity of TST were 73% [95% confidence interval (CI): 53-91] and 97% (95%CI: 89-100), respectively, versus 53% (95%CI: 41-66) and 81% (95%CI:71-90) for QFT. The positive predictive value of TST in children with TB-HCC was 91% (95%CI: 61-99), being 74% for QFT (95%CI: 47-95). Conclusions This is one of the first studies to estimate the prevalence of LTBI in children and the parameters of the main diagnostic tests using a latent class model. Our results suggest that children in contact with an index case have a high risk of infection. The accuracy and the predictive value of the two tests did not significantly differ. Combined use of the two tests showed scarce improvement in the diagnosis of LTBI.
publishDate 2016
dc.date.none.fl_str_mv 2016
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://hdl.handle.net/2445/113707
url https://hdl.handle.net/2445/113707
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv Reproducció del document publicat a: https://doi.org/10.1371/journal.pone.0164181
PLoS One, 2016, vol. 11, num. 10, p. e0164181
https://doi.org/10.1371/journal.pone.0164181
dc.rights.none.fl_str_mv cc-by (c) Pérez-Porcuna, Tomàs M. et al., 2016
http://creativecommons.org/licenses/by/3.0/es
info:eu-repo/semantics/openAccess
rights_invalid_str_mv cc-by (c) Pérez-Porcuna, Tomàs M. et al., 2016
http://creativecommons.org/licenses/by/3.0/es
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv Public Library of Science (PLoS)
publisher.none.fl_str_mv Public Library of Science (PLoS)
dc.source.none.fl_str_mv Articles publicats en revistes (Fonaments Clínics)
reponame:Dipòsit Digital de la UB
instname:Universidad de Barcelona
instname_str Universidad de Barcelona
reponame_str Dipòsit Digital de la UB
collection Dipòsit Digital de la UB
repository.name.fl_str_mv
repository.mail.fl_str_mv
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