title: Role of the QuantiFERON(R)-TB Gold In-Tube assay in screening new immigrants for tuberculosis infection.
abstract: This study aimed to estimate the risk of progression to active tuberculosis (TB) within 2 yrs after entry in newly arriving immigrants who were screened with the QuantiFERON®-TB Gold In-Tube assay (QFT-GIT; Cellestis, Carnegie, Australia). In a case-base design, we determined the prevalence QFT-GIT-positive subjects among a representative sample of immigrants aged ≥ 18 yrs who arrived between April 2009 and March 2011 (the base cohort). Active TB patients (cases) within 2 yrs post-arrival in 2005, 2006 or 2007 were extracted from the Netherlands Tuberculosis Register. The risk of progression to active TB was estimated using Bayesian analyses to adjust for the sensitivity of QFT-GIT. Among the base cohort, 20% of 1,468 immigrants were QFT-GIT positive. Stratified by TB incidence in the person's country of origin as low (<100 cases per 100,000 population), intermediate (100-199 cases per 100,000) or high (≥ 200 cases per 100,000), the risk of progression to active TB per 100,000 arriving immigrants if QFT-GIT positive (95% credibility interval) was 456 (95% CI 307-589), 590 (397-762) and 386 (259-499), respectively, compared with 18 (0-46), 38 (0-97) and 28 (0-71) if QFT-GIT negative. Screening newly arriving immigrants with QFT-GIT contributes to detecting those at high risk of subsequent TB reactivation within 2 yrs after entry, which offers opportunities for prevention by targeted interventions.
authors.affiliation: KNCV Tuberculosis Foundation, The Hague, the Netherlands. mulderc@kncvtbc.nl
authors.forename: Christiaan
authors.initials: C
authors.lastname: Mulder
authors.forename: Henk
authors.initials: H
authors.lastname: van Deutekom
authors.forename: Erik M
authors.initials: EM
authors.lastname: Huisman
authors.forename: Sophie
authors.initials: S
authors.lastname: Toumanian
authors.forename: Ben F P J
authors.initials: BF
authors.lastname: Koster
authors.forename: Wieneke
authors.initials: W
authors.lastname: Meijer-Veldman
authors.forename: Joke H
authors.initials: JH
authors.lastname: van Loenhout-Rooyackers
authors.forename: Milo
authors.initials: M
authors.lastname: Appel
authors.forename: Sandra M
authors.initials: SM
authors.lastname: Arend
authors.forename: Martien W
authors.initials: MW
authors.lastname: Borgdorff
authors.forename: Frank
authors.initials: F
authors.lastname: van Leth
mesh_terms: D000293:Adolescent; D000328:Adult; D001499:Bayes Theorem; D015331:Cohort Studies; D003140:Communicable Disease Control; D003362:Cost-Benefit Analysis; D018450:Disease Progression; D054242:Emigrants and Immigrants; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening; D009426:Netherlands; D015995:Prevalence; D011933:Reagent Kits, Diagnostic; D012680:Sensitivity and Specificity; D014374:Tuberculin Test / Q000379:methods; D014376:Tuberculosis / Q000175:diagnosis* / Q000382:microbiology
chemical_list: D011933:Reagent Kits, Diagnostic