Parasitic infection may be associated with discordant responses to QuantiFERON and tuberculin skin test in apparently healthy children and adolescents in a tuberculosis endemic setting, Ethiopia

BMC Infectious Diseases

Mark T Doherty²  Peter Andersen³  Lawrence K Yamuah¹  Hiwot Tilahun¹  Menberwork Chanyalew¹  Girum Erenso¹  Adane Mihret¹  Martha Zewdie¹  Michael Z Gebeyehu¹  Markos Abebe¹  Abraham Aseffa¹  Liya Wassie³ 

[1]Armauer Hansen Research Institute, Jimma Road, P.O. Box: 1005 Addis Ababa, Ethiopia

[2]Current Address: GlaxoSmithKline, 68 Nykær, Copenhagen, Denmark

[3]Infectious Disease Immunology, Statens Serum Institute, Artillerivej 5 2300 S, Copenhagen, Denmark

关键词: Parasites;    Children;    Adolescents;    TST;    QuantiFERON;    Latent tuberculosis;   

Others  :  1147941
DOI  :  10.1186/1471-2334-13-265

 received in 2012-10-25, accepted in 2013-05-29,  发布年份 2013

【 摘 要 】

Background

M. tuberculosis remains one of the world’s deadliest pathogens in part because of its ability to establish persistent, latent infections, which can later reactivate to cause disease. In regions of the globe where disease is endemic, as much as 50% of the population is thought to be latently infected, complicating diagnosis and tuberculosis control. The tools most commonly used for diagnosis of latent M. tuberculosis infection are the tuberculin skin test and the newer interferon-gamma release assays, both of which rely on an antigen-specific memory response as an indicator of infection. It is clear that the two tests, do not always give concordant results, but the factors leading to this are only partially understood.

Methods

In this study we examined 245 healthy school children aged from 12 to 20 years from Addis Ababa, a tuberculosis-endemic region, characterised them with regard to response in the tuberculin skin test and QuantIFERON™ test and assessed factors that might contribute to discordant responses.

Results

Although concordance between the tests was generally fair (90% concordance), there was a subset of children who had a positive QuantIFERON™ result but a negative tuberculin skin test. After analysis of multiple parameters the data suggest that discordance was most strongly associated with the presence of parasites in the stool.

Conclusions

Parasitic gut infections are frequent in most regions where M. tuberculosis is endemic. This study, while preliminary, suggests that the tuberculin skin test should be interpreted with caution where this may be the case.

【 授权许可】

   
2013 Wassie et al.; licensee BioMed Central Ltd.

【 图 表 】

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