Fritschi, Nora;
Gureva, Tatyana;
Eliseev, Platon;
Jackson, Charlotte;
Milanzi, Edith;
Crichton, Siobhan;
Collins, Intira Jeannie;
... Ritz, Nicole; + view all
(2024)
Diagnosis of tuberculosis infection in children
with a novel skin test and the traditional
tuberculin skin test: An observational study.
PLoS ONE
, 19
(8)
, Article e0293272. 10.1371/journal.pone.0293272.
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Abstract
Background: A novel skin test–called Diaskintest (DT)—containing specific M. tuberculosis antigens is in clinical use in the Russian Federation (RF). This test may improve diagnosis of tuberculosis (TB) infection. The use and performance of the DT was described and compared to the tuberculin skin test (TST). // Methods: Data on children <18 years referred to a TB reference centre (Jan/2018- Dec/2019) with ≥1 DT and TST result available were analysed. An immune correlate of TB infection was defined as a positive TST (≥10 mm induration) or a positive DT (any induration). // Results: Of 2710 included cases, the median age was 9.0 (IQR 5.7–13.1) years and 97.5% were BCG immunised. Overall, 1976 (79.9%) were TB uninfected, 724 (26.7%) had an immune correlate of TB infection and 10 (0.4%) TB disease. Reasons for referral were: positive or increasing skin test results in routine screening (992, 36.6%), screening before admission to a health care institution (501, 18.5%) and TB contact (457, 16.9%). DT was positive in 11.7% (308/2625) and TST in 63.1% (467/740) (Kappa 0.08, 95% CI:0.013–0.14). A positive DT was associated with older age (OR 1.16 (95% CI: 1.13–1.19) per year). Among TB contacts DT positivity was associated with contagiousness: highest proportion of positivity of 12.0% was observed when the index case was smear positive. // Conclusion: In a setting with universal BCG vaccination and regular screening with TST, DT was used to rule out TB infection as TST was commonly positive. We found an association of DT positivity and contagiousness of the index case in children contacts. These observations may suggest improved specificity and sensitivity of DT compared to TST.
| Type: | Article |
|---|---|
| Title: | Diagnosis of tuberculosis infection in children with a novel skin test and the traditional tuberculin skin test: An observational study |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1371/journal.pone.0293272 |
| Publisher version: | http://dx.doi.org/10.1371/journal.pone.0293272 |
| Language: | English |
| Additional information: | Copyright © 2024 Fritschi et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, https://creativecommons.org/licenses/by/4.0/, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Inst of Clinical Trials and Methodology UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Inst of Clinical Trials and Methodology > MRC Clinical Trials Unit at UCL |
| URI: | https://discovery-pp.ucl.ac.uk/id/eprint/10196337 |
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