Elsevier

The Lancet

Volume 384, Issue 9959, 6–12 December 2014, Page 2026
The Lancet

Correspondence
Shortage of purified protein derivative for tuberculosis testing

https://doi.org/10.1016/S0140-6736(14)62335-7Get rights and content

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    By use of a well established research network, predominately comprising paediatric infectious diseases specialists and paediatric pulmonologists, the aim of this study was to rapidly capture key data on COVID-19 in children in Europe on a large scale, to aid physicians in Europe and in other geographical locations with service planning and allocation of resources. For this cohort study, European members of the Paediatric Tuberculosis Network European Trials Group (ptbnet)—which currently includes 304 clinicians and researchers, most of whom are based at tertiary or quaternary paediatric infectious diseases or paediatric pulmonology units, across 128 paediatric health-care institutions in 31 European countries15–20—were invited to contribute cases of confirmed SARS-CoV-2 infection that had been managed at or managed remotely by their health-care institution (including individuals admitted to other hospitals or identified during community screening) before or during the study period. Any individual aged 18 years or younger with SARS-CoV-2 infection confirmed by RT-PCR was eligible for inclusion.

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    This finding should be interpreted carefully as different low TB incidence settings may vary in what they regard as a locally-relevant cost/QALY cut off [31]. Further, the selection of either TST or an IGRA as a preferred test can depend on factors such as the availability of Purified Protein Derivative for TST, or the programmatic simplicity of not needing to recall people with a negative blood IGRA [32]. Our study has several limitations.

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    It improves on the specificity of the TST in settings where BCG coverage is high, which suggests that if C-Tb were available worldwide, it could have a substantial effect on morbidity and health expenditure.27 Furthermore, as the manufacturing process for C-Tb is modern and simple compared with that for PPD, the periodic shortages that have been seen for the TST28 seems less likely to occur with C-Tb. Our data in this double-blind, randomised clinical trial show that C-Tb was safe, detected similar numbers of people with M tuberculosis infection with very high concordance to QFT in individuals aged 5 years and older, and showed good specificity in negative controls.

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