The validity and limitations of IGRA (QFT-GIT) and TST in screening for pulmonary tuberculosis among adults applying for residency in the Emirate of Abu Dhabi, UAE in 2013

Mycobacterium tuberculosis;Interferon Gamma Release Assay;Public Health Studies

Alshemeili, Huda SaeedGolub, Jonathan ;

Johns Hopkins University

关键词: Mycobacterium tuberculosis;    Interferon Gamma Release Assay;    Public Health Studies;   

Others  :  https://jscholarship.library.jhu.edu/bitstream/handle/1774.2/60063/ALSHEMEILI-DISSERTATION-2018.pdf?sequence=1&isAllowed=y

瑞士|英语

来源: JOHNS HOPKINS DSpace Repository

【 摘 要 】

Mycobacterium tuberculosis (MTB), the agent causing tuberculosis (TB) and latent tuberculosis infection (LTBI) imposes a significant public health concern world-wide. The utility and the value for simultaneous (parallel) testing with Interferon Gamma Release Assay [IGRA (QFT-GIT)] and Tuberculin skin test (TST) in detecting MTB infection among applicants for residency in Abu Dhabi requires evaluation. The objectives of this study are to 1) Provide demographic characteristics of the study sample by age categories, and 2) Explore the validity measures of IGRA (QFT-GIT) and TST, and 3) Further, to assess the risk of MTB among younger visa applicants compared to older applicants.This cross-sectional study analyzes data routinely collected on all adults (18-64 years) seeking a residency visa in the Emirate of Abu Dhabi from January – December 2013. Among the 1,529,389 adults who applied for this visa in 2013, 2,596 individuals presented with an abnormal chest X-ray (and who also were HIV negative).In our study, nearly two-thirds of males in the sample were from Pakistan and India while almost 50% of females were from the Philippines. The sensitivity of IGRA (QFT-GIT) test was 72.7%, (95% CI: 67.8-77.2) compared to TST sensitivity of 59.1%, (95% CI: 53.8-64.2), (P<0.001). The net sensitivity of simultaneous (parallel) testing was 88.8%. The net sensitivity of simultaneous (parallel) testing for the younger age group (18-34) years was 91.6% compared to 83.1% net sensitivity among older individuals (35-64) years. Kappa agreement between IGRA (QFT-GIT) and TST was 0.33 (95% CI: 0.29-0.36). The role of chest X-ray in our study was not adequate and older individuals (35-64) years had lower proportions of MTB infection when compared to younger individuals (18-34) years, yielding an Odds Ratio (OR) of 0.62 (95% CI 0.48– 0.81), (P<0.001).In conclusion, nearly two-thirds of males in the sample were from Pakistan and India. IGRA (QFT-GIT) was more sensitive than TST. The net sensitivity of simultaneous (parallel) testing was high. However, Kappa agreement between IGRA (QFT-GIT) and TST in the study was considered as only fair concordance.Primary Reader: David CelentanoSecondary Readers: Lilly Engineer, Jonathan Golub, Josh Sharfstein, Amal Mohammed