The tuberculin skin test versus QuantiFERON TB Gold® in predicting tuberculosis disease in an adolescent cohort study in South Africa

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dc.contributor.authorMahomed, Hassanen_ZA
dc.contributor.authorHawkridge, Tonyen_ZA
dc.contributor.authorVerver, Suzanneen_ZA
dc.contributor.authorAbrahams, Deborahen_ZA
dc.contributor.authorGeiter, Lawrenceen_ZA
dc.contributor.authorHatherill, Marken_ZA
dc.contributor.authorEhrlich, Rodneyen_ZA
dc.contributor.authorHanekom, Willem Aen_ZA
dc.contributor.authorHussey, Gregory Den_ZA
dc.date.accessioned2015-12-20T16:04:43Z
dc.date.available2015-12-20T16:04:43Z
dc.date.issued2011en_ZA
dc.description.abstractSetting This study was conducted in a high tuberculosis (TB) burden area in Worcester, South Africa, with a notified all TB incidence rate of 1,400/100,000. Main Objective To compare the predictive value of a baseline tuberculin skin test (TST) with that of the QuantiFERON TB Gold (In-tube) assay (QFT) for subsequent microbiologically confirmed TB disease among adolescents. METHODS: Adolescents aged 12-18 years were recruited from high schools in the study area. At baseline, blood was drawn for QFT and a TST administered. Participants were followed up for up to 3.8 years for incident TB disease (median 2.4 years). RESULTS: After exclusions, 5244 (82.4%) of 6,363 adolescents enrolled, were analysed. The TB incidence rate was 0.60 cases per 100 person years (pyrs) (95% CI 0.43-0.82) for baseline TST positive (≥5 mm) participants and 0.64 cases per 100 pyrs (95% CI 0.45-0.87) for baseline QFT positive participants. TB incidence rates were 0.22 per 100 pyrs (0.11-0.39) and 0.22 per 100 pyrs (0.12-0.38) among those with a negative baseline TST and QFT respectively. Sensitivity for incident TB disease was 76.9% for TST and 75.0% for QFT (p = 0.81). Positive predictive value was 1.4% for TST and 1.5% for QFT. CONCLUSION: Positive TST and QFT tests were moderately sensitive predictors of progression to microbiologically confirmed TB disease. There was no significant difference in the predictive ability of these tests for TB disease amongst adolescents in this high burden setting. Therefore, these findings do not support use of QFT in preference to TST to predict the risk of TB disease in this study population.en_ZA
dc.identifier.apacitationMahomed, H., Hawkridge, T., Verver, S., Abrahams, D., Geiter, L., Hatherill, M., ... Hussey, G. D. (2011). The tuberculin skin test versus QuantiFERON TB Gold® in predicting tuberculosis disease in an adolescent cohort study in South Africa. <i>PLoS One</i>, http://hdl.handle.net/11427/15914en_ZA
dc.identifier.chicagocitationMahomed, Hassan, Tony Hawkridge, Suzanne Verver, Deborah Abrahams, Lawrence Geiter, Mark Hatherill, Rodney Ehrlich, Willem A Hanekom, and Gregory D Hussey "The tuberculin skin test versus QuantiFERON TB Gold® in predicting tuberculosis disease in an adolescent cohort study in South Africa." <i>PLoS One</i> (2011) http://hdl.handle.net/11427/15914en_ZA
dc.identifier.citationMahomed, H., Hawkridge, T., Verver, S., Abrahams, D., Geiter, L., Hatherill, M., ... & Hussey, G. D. (2011). The tuberculin skin test versus QuantiFERON TB Gold® in predicting tuberculosis disease in an adolescent cohort study in South Africa. PLoS One, 6(3), e17984. doi:10.1371/journal.pone.0017984en_ZA
dc.identifier.ris TY - Journal Article AU - Mahomed, Hassan AU - Hawkridge, Tony AU - Verver, Suzanne AU - Abrahams, Deborah AU - Geiter, Lawrence AU - Hatherill, Mark AU - Ehrlich, Rodney AU - Hanekom, Willem A AU - Hussey, Gregory D AB - Setting This study was conducted in a high tuberculosis (TB) burden area in Worcester, South Africa, with a notified all TB incidence rate of 1,400/100,000. Main Objective To compare the predictive value of a baseline tuberculin skin test (TST) with that of the QuantiFERON TB Gold (In-tube) assay (QFT) for subsequent microbiologically confirmed TB disease among adolescents. METHODS: Adolescents aged 12-18 years were recruited from high schools in the study area. At baseline, blood was drawn for QFT and a TST administered. Participants were followed up for up to 3.8 years for incident TB disease (median 2.4 years). RESULTS: After exclusions, 5244 (82.4%) of 6,363 adolescents enrolled, were analysed. The TB incidence rate was 0.60 cases per 100 person years (pyrs) (95% CI 0.43-0.82) for baseline TST positive (≥5 mm) participants and 0.64 cases per 100 pyrs (95% CI 0.45-0.87) for baseline QFT positive participants. TB incidence rates were 0.22 per 100 pyrs (0.11-0.39) and 0.22 per 100 pyrs (0.12-0.38) among those with a negative baseline TST and QFT respectively. Sensitivity for incident TB disease was 76.9% for TST and 75.0% for QFT (p = 0.81). Positive predictive value was 1.4% for TST and 1.5% for QFT. CONCLUSION: Positive TST and QFT tests were moderately sensitive predictors of progression to microbiologically confirmed TB disease. There was no significant difference in the predictive ability of these tests for TB disease amongst adolescents in this high burden setting. Therefore, these findings do not support use of QFT in preference to TST to predict the risk of TB disease in this study population. DA - 2011 DB - OpenUCT DO - 10.1371/journal.pone.0017984 DP - University of Cape Town J1 - PLoS One LK - https://open.uct.ac.za PB - University of Cape Town PY - 2011 T1 - The tuberculin skin test versus QuantiFERON TB Gold® in predicting tuberculosis disease in an adolescent cohort study in South Africa TI - The tuberculin skin test versus QuantiFERON TB Gold® in predicting tuberculosis disease in an adolescent cohort study in South Africa UR - http://hdl.handle.net/11427/15914 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/15914
dc.identifier.urihttp://dx.doi.org/10.1371/journal.pone.0017984
dc.identifier.vancouvercitationMahomed H, Hawkridge T, Verver S, Abrahams D, Geiter L, Hatherill M, et al. The tuberculin skin test versus QuantiFERON TB Gold® in predicting tuberculosis disease in an adolescent cohort study in South Africa. PLoS One. 2011; http://hdl.handle.net/11427/15914.en_ZA
dc.language.isoengen_ZA
dc.publisherPublic Library of Scienceen_ZA
dc.publisher.departmentSouth African Tuberculosis Vaccine Initiative (SATVI)en_ZA
dc.publisher.facultyFaculty of Health Sciencesen_ZA
dc.publisher.institutionUniversity of Cape Town
dc.rightsThis is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.en_ZA
dc.rights.holder© 2011 Mahomed et alen_ZA
dc.rights.urihttp://creativecommons.org/licenses/by/4.0en_ZA
dc.sourcePLoS Oneen_ZA
dc.source.urihttp://journals.plos.org/plosoneen_ZA
dc.subject.otherTuberculosisen_ZA
dc.subject.otherAdolescentsen_ZA
dc.subject.otherTuberculosis diagnosis and managementen_ZA
dc.subject.otherMycobacterium tuberculosisen_ZA
dc.subject.otherHistory of tuberculosisen_ZA
dc.subject.otherSputumen_ZA
dc.subject.otherCohort studiesen_ZA
dc.subject.otherTuberculinen_ZA
dc.titleThe tuberculin skin test versus QuantiFERON TB Gold® in predicting tuberculosis disease in an adolescent cohort study in South Africaen_ZA
dc.typeJournal Articleen_ZA
uct.type.filetypeText
uct.type.filetypeImage
uct.type.publicationResearchen_ZA
uct.type.resourceArticleen_ZA
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