Brief ReportDiagnostic Accuracy of QuantiFERON-TB Gold Plus Assays in Children and Adolescents with Tuberculosis Disease
Section snippets
Methods
We performed a cross-sectional study within the Spanish Pediatric TB Research Network (pTBred),7 which includes 83 participating centers. Patients <18 years of age diagnosed with TB are eligible for inclusion in the pTBred database. Data are collected using Research Electronic Data Capture electronic data capture tools, hosted at Instituto de Investigación Sanitaria Gregorio Marañón. Approval for pTBred was obtained from the Hospital Carlos III Madrid Ethics Committee (ref.P13/12). Informed
Results
During the study period, 168 children diagnosed with TB disease were included in the pTBred database; 158 had QFT-Plus results: 131 were positive (82.9%), 25 negative (15.8%), and 2 indeterminate (1.3%, both because of insufficient mitogen responses) (Table I). The median age was 5.3 (IQR 2.4-11.6) years. Most patients had been born in Spain (73.4%) and were BCG-unvaccinated (73.4%). Nine (5.7%) had significant comorbidities: Down syndrome (n = 3), malnutrition (n = 2) and acute lymphoblastic
Discussion
This large study on the performance of QFT-Plus assays in children and adolescents with TB disease showed sensitivity of QFT-Plus assay of 82.9%, highlighting that approximately 1 in 5 children with TB have a false-negative test result when this assay is used as an adjunctive test. Importantly, this shows that in the context of TB disease, the new generation assay does not perform better than previous generation QFT assays, which had a pooled sensitivity of 83% in a well-designed meta-analysis
Data Statement
Data sharing statement available at www.jpeds.com.
References (12)
Global tuberculosis report 2018. WHO 2019
- et al.
Interferon-gamma release assays and childhood tuberculosis: systematic review and meta-analysis
Int J Tuberc Lung Dis
(2011) - et al.
Diagnostic tests for childhood tuberculosis: Past imperfect, present tense and future perfect?
Pediatr Infect Dis J
(2015) - et al.
Availability and use of molecular microbiological and immunological tests for the diagnosis of tuberculosis in Europe
PLoS One
(2014) - et al.
Sensitivity and characteristics associated with positive QuantiFERON-TB Gold-Plus assay in children with confirmed tuberculosis
PLoS One
(2019) - et al.
Evaluation of the QuantiFERON-Tuberculosis gold plus assay in children with tuberculosis disease or following household exposure to tuberculosis
Am J Trop Med Hyg
(2019)
Cited by (15)
Update on the diagnosis and treatment of tuberculosis
2023, Anales de PediatriaUtility of interferon-gamma releasing assay for the diagnosis of active tuberculosis in children: A systematic review and meta-analysis
2023, Journal of Infection and ChemotherapyInterferon-Gamma Release Assays Differentiate between Mycobacterium avium Complex and Tuberculous Lymphadenitis in Children
2021, Journal of PediatricsCitation Excerpt :A cross-sectional study was performed within the Spanish Network for the Study of Pediatric TB (pTBred) and the European NontuberculouS MycoBacterial Lymphadenitis in childrEn (ENSeMBLE) Study. pTBred is a multidisciplinary collaborative network comprising health care professionals managing children with TB in Spain, and currently includes 148 members across 83 institutions.19,20 Patients age <18 years diagnosed with TB disease are eligible for inclusion in the pTBred database.
Mediastinal mass in an tuberculosis-exposed 2-year old child with neurofibromatosis type 1 – TB or not TB?
2021, Respiratory Medicine Case ReportsCitation Excerpt :Children may initially be asymptomatic. Moreover, IGRA and TST can be negative in infected children [2]. Therefore, a hilar or mediastinal mass in an TB-exposed young child is highly suspicious for tuberculosis, irrespective of IGRA and TST results or clinical symptom unless a differential diagnosis can clearly be established.
The Value of the Second QuantiFERON-TB Gold-Plus Antigen Tube at Diagnosis and at Treatment Completion in Spanish Children With Tuberculosis
2023, Pediatric Infectious Disease JournalQuantiFERON-TB Gold Plus Performance in Children: A Narrative Review
2023, Pediatric Infectious Disease Journal
Supported by “Subvencions per a la Intensificació de Facultatius Especialistes” (Departament de Salut de la Generalitat de Catalunya, Programa PERIS 2016-2020) (SLT008/18/00193 [to A.N-J.]). M.T. has received QuantiFERON assays at reduced pricing or free of charge for TB diagnostics projects from the manufacturer (Cellestis/Qiagen) in the past, and has received support for conference attendance from Cepheid. The manufacturers had no influence on the study design, data collection, analysis or interpretation, writing of the manuscript or decision to submit the data for publication. The other authors declare no conflicts of interest.
- ∗
Contributed equally.
- †
List of additional members of the QFT-Plus Study Group of the Spanish Pediatric TB Research Network is available at www.jpeds.com (Appendix).