Predictors of discordant latent tuberculosis infection test results amongst South African health care workers
| dc.contributor.author | Adams, Shahieda | |
| dc.contributor.author | Ehrlich, Rodney | |
| dc.contributor.author | Baatjies, Roslynn | |
| dc.contributor.author | Dendukuri, Nandini | |
| dc.contributor.author | Wang, Zhuoyu | |
| dc.contributor.author | Dheda, Keertan | |
| dc.date.accessioned | 2019-02-14T12:57:32Z | |
| dc.date.available | 2019-02-14T12:57:32Z | |
| dc.date.issued | 2019-02-08 | |
| dc.date.updated | 2019-02-10T04:17:55Z | |
| dc.description.abstract | Background The tuberculin skin test (TST) and interferon-gamma-release-assays (IGRAs) are utilized in screening programmes for presumed latent tuberculosis infection (LTBI) in health care workers (HCWs). However, inter-test comparison yields high rates of discordance, which is poorly understood. The aim of the study was therefore to identify factors associated with discordance amongst HCWs in a TB and HIV endemic setting. Methods 505 HCWs were screened for LTBI in South Africa using the TST and two IGRA assays (QuantiFERON-TB-Gold-In-Tube (QFT-GIT) and TSPOT.TB). Factors associated with discordance were analyzed using a multinomial logistic regression model. Results TST-IGRA discordance was negatively associated with longer duration of employment for both TSPOT.TB (OR = 0.92; 95% confidence interval (CI) 0.85–0.99) and QFT-GIT (OR = 0.90; 95% CI 0.84–0.96). Marked test discordance occurred in HIV-infected individuals who were more likely to have TSPOT.TB + ve / TST-ve discordance (OR 4.44; 95% CI 1.14–17.27) or TSPOT.TB + ve / QFT-GIT-ve test discordance (OR 5.72; 95% CI 1.95–16.78). Those engaged in home care were less likely to have QFT-GIT + ve/TSPOT.TB -ve / discordance (OR 0.32; 95% CI 0.10–0.95). Conclusion The marked TST-IGRA and IGRA-IGRA discordance in HIV-infected individuals suggest greater sensitivity of TSPOT.TB in immunocompromised persons or potential greater reactivity of TSPOT.TB in this population. | |
| dc.identifier.apacitation | Adams, S., Ehrlich, R., Baatjies, R., Dendukuri, N., Wang, Z., & Dheda, K. (2019). Predictors of discordant latent tuberculosis infection test results amongst South African health care workers. http://hdl.handle.net/11427/29521 | en_ZA |
| dc.identifier.chicagocitation | Adams, Shahieda, Rodney Ehrlich, Roslynn Baatjies, Nandini Dendukuri, Zhuoyu Wang, and Keertan Dheda "Predictors of discordant latent tuberculosis infection test results amongst South African health care workers." (2019) http://hdl.handle.net/11427/29521 | en_ZA |
| dc.identifier.citation | Adams, S., Ehrlich, R., Baatjies, R., Dendukuri, N., Wang, Z., & Dheda, K. (2019). Predictors of discordant latent tuberculosis infection test results amongst South African health care workers. BMC Infectious Diseases, 19(1), 131. | |
| dc.identifier.ris | TY - Journal Article AU - Adams, Shahieda AU - Ehrlich, Rodney AU - Baatjies, Roslynn AU - Dendukuri, Nandini AU - Wang, Zhuoyu AU - Dheda, Keertan AB - Background The tuberculin skin test (TST) and interferon-gamma-release-assays (IGRAs) are utilized in screening programmes for presumed latent tuberculosis infection (LTBI) in health care workers (HCWs). However, inter-test comparison yields high rates of discordance, which is poorly understood. The aim of the study was therefore to identify factors associated with discordance amongst HCWs in a TB and HIV endemic setting. Methods 505 HCWs were screened for LTBI in South Africa using the TST and two IGRA assays (QuantiFERON-TB-Gold-In-Tube (QFT-GIT) and TSPOT.TB). Factors associated with discordance were analyzed using a multinomial logistic regression model. Results TST-IGRA discordance was negatively associated with longer duration of employment for both TSPOT.TB (OR = 0.92; 95% confidence interval (CI) 0.85–0.99) and QFT-GIT (OR = 0.90; 95% CI 0.84–0.96). Marked test discordance occurred in HIV-infected individuals who were more likely to have TSPOT.TB + ve / TST-ve discordance (OR 4.44; 95% CI 1.14–17.27) or TSPOT.TB + ve / QFT-GIT-ve test discordance (OR 5.72; 95% CI 1.95–16.78). Those engaged in home care were less likely to have QFT-GIT + ve/TSPOT.TB -ve / discordance (OR 0.32; 95% CI 0.10–0.95). Conclusion The marked TST-IGRA and IGRA-IGRA discordance in HIV-infected individuals suggest greater sensitivity of TSPOT.TB in immunocompromised persons or potential greater reactivity of TSPOT.TB in this population. DA - 2019-02-08 DB - OpenUCT DP - University of Cape Town LK - https://open.uct.ac.za PY - 2019 T1 - Predictors of discordant latent tuberculosis infection test results amongst South African health care workers TI - Predictors of discordant latent tuberculosis infection test results amongst South African health care workers UR - http://hdl.handle.net/11427/29521 ER - | en_ZA |
| dc.identifier.uri | https://doi.org/10.1186/s12879-019-3745-5 | |
| dc.identifier.uri | http://hdl.handle.net/11427/29521 | |
| dc.identifier.vancouvercitation | Adams S, Ehrlich R, Baatjies R, Dendukuri N, Wang Z, Dheda K. Predictors of discordant latent tuberculosis infection test results amongst South African health care workers. 2019; http://hdl.handle.net/11427/29521. | en_ZA |
| dc.language.iso | en | |
| dc.publisher | BioMed Central | |
| dc.rights.holder | The Author(s). | |
| dc.subject.other | Latent tuberculosis infection | |
| dc.subject.other | Sensitivity | |
| dc.subject.other | Specificity | |
| dc.subject.other | Discordance and health care worker | |
| dc.title | Predictors of discordant latent tuberculosis infection test results amongst South African health care workers | |
| dc.type | Journal Article |