title: QuantiFERON-TB Gold In-Tube for the detection of Mycobacterium tuberculosis infection in children with household tuberculosis contact.
abstract: METHODS
  Improved strategies are needed for detecting Mycobacterium tuberculosis infection in children in TB-endemic settings.
  
  
  OBJECTIVE
  To determine the prevalence of M. tuberculosis infection by tuberculin skin testing (TST) and by the QuantiFERON-TB Gold In-Tube (QFT-GIT) test in children with an adult household contact with pulmonary TB in South Africa.
  
  
  METHODS
  Cross-sectional study.
  
  
  RESULTS
  A total of 167 adult pulmonary TB cases (153/167, 92% human immunodeficiency virus [HIV] infected) and 270 pediatric contacts (median age 6 years, 14/270, 5% HIV-infected) were enrolled. All children completed QFT-GIT testing and 254 (94.1%) completed TST testing. Prevalence of M. tuberculosis infection was 28% (71/254, 95%CI 23-34) using TST (5 mm cut-off) and 29% (79/270, 95%CI 24-35) using QFT-GIT (P = 0.49). Agreement between TST and QFT-GIT was 81% (kappa 0.58). Nineteen (7%) QFT-GIT results were indeterminate. Children aged <2 years were more likely than older children to have indeterminate QFT-GIT results (aOR 5.7, 95%CI 1.5-22, P = 0.01) and discordant QFT-GIT and TST results (aOR 3.5, 95%CI 1.7-7.6, P = 0.001).
  
  
  CONCLUSIONS
  Prevalence of M. tuberculosis infection in pediatric contacts was high regardless of the diagnostic method used. TST should not be excluded for the detection of pediatric M. tuberculosis infection in this setting, but QFT-GIT may be a feasible alternative in children aged ≥ 2 years.
authors.affiliation: Johns Hopkins University School of Medicine, Baltimore, Maryland, USA. TKasambira@gmail.com
authors.forename: T S
authors.initials: TS
authors.lastname: Kasambira
authors.forename: M
authors.initials: M
authors.lastname: Shah
authors.forename: P V
authors.initials: PV
authors.lastname: Adrian
authors.forename: M
authors.initials: M
authors.lastname: Holshouser
authors.forename: S A
authors.initials: SA
authors.lastname: Madhi
authors.forename: R E
authors.initials: RE
authors.lastname: Chaisson
authors.forename: N A
authors.initials: NA
authors.lastname: Martinson
authors.forename: S E
authors.initials: SE
authors.lastname: Dorman
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005191:Family Characteristics; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007223:Infant; D007371:Interferon-gamma / Q000097:blood*; D008297:Male; D009169:Mycobacterium tuberculosis / Q000276:immunology / Q000302:isolation & purification*; D015995:Prevalence; D011933:Reagent Kits, Diagnostic; D014374:Tuberculin Test / Q000379:methods*; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis* / Q000453:epidemiology / Q000382:microbiology
chemical_list: D011933:Reagent Kits, Diagnostic; D007371:Interferon-gamma