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Title: Mycobacterium tuberculosis Infection in Young Children: Analyzing the Performance of the Diagnostic Tests
Author: Pérez-Porcuna, Tomàs M.
Ascaso Terrén, Carlos
Malheiro, Adriana
Abellana Sangrà, Rosa Mari
Martins, Marilaine
Jardim Sardinha, José Felipe
Quincó Patricia
Antunes, Irineide Assumpçao
da Silva Garrido, Marlucia
Bührer-Sékula, Samira
Martinez-Espinosa, Flor Ernestina
Keywords: Mycobacterium tuberculosis
Mycobacterium tuberculosis
Issue Date: 30-May-2014
Publisher: Public Library of Science (PLoS)
Abstract: This study evaluated the performance of the Tuberculin Skin Test (TST) and Quantiferon-TB Gold in-Tube (QFT) and the possible association of factors which may modify their results in young children (0-6 years) with recent contact with an index tuberculosis case. Materials and Methods: A cross-sectional study including 135 children was conducted in Manaus, Amazonas-Brazil. The TST and QFT were performed and the tests results were analyzed in relation to the personal characteristics of the children studied and their relationship with the index case. Results: The rates of positivity were 34.8% (TST) and 26.7% (QFT), with 14.1% of indeterminations by the QFT. Concordance between tests was fair (Kappa = 0.35 P<0.001). Both the TST and QFT were associated with the intensity of exposure (Linear OR = 1.286, P = 0.005; Linear OR = 1.161, P = 0.035 respectively) with only the TST being associated with the time of exposure (Linear OR = 1.149, P = 0.009). The presence of intestinal helminths in the TST+ group was associated with negative QFT results (OR = 0.064, P = 0.049). In the TST- group lower levels of ferritin were associated with QFT+ results (Linear OR = 0.956, P = 0.036). Conclusions: Concordance between the TST and QFT was lower than expected. The factors associated with the discordant results were intestinal helminths, ferritin levels and exposure time to the index tuberculosis case. In TST+ group, helminths were associated with negative QFT results suggesting impaired cell-mediated immunity. The TST-&QFT+ group had a shorter exposure time and lower ferritin levels, suggesting that QFT is faster and ferritin may be a potential biomarker of early stages of tuberculosis infection.
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It is part of: PLoS One, 2014, vol. 9, num. 5
ISSN: 1932-6203
Appears in Collections:Articles publicats en revistes (Medicina)

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