title: Implementation of an interferon-gamma release assay to screen for tuberculosis in refugees and immigrants.
abstract: Despite increased use and accuracy of interferon-gamma release assays to detect latent tuberculosis infection (LTBI) in foreign-born arrivals in the United States, risk characteristics associated with positive results are not well characterized. We conducted a retrospective record review of 541 refugees and immigrants screened for LTBI with QuantiFERON(®)-TB Gold In-Tube (QFT-IT) at the Spokane Public Health Clinic from January 2, 2008, through June 5, 2009. Overall, 24 % of the arrivals had a positive QFT-IT, with the greatest frequency of positive results occurring in arrivals from Liberia (100 %) and Bhutan (39 %). More than the expected number of Burmese had indeterminate QFT-IT results. A positive QFT-IT was associated with age, race, ethnicity, and extent of TB burden in the country of origin. QFT-IT is useful to screen for LTBI in foreign-born arrivals, particularly middle-aged adults from high-burden countries. However, the QFT-IT may not yield meaningful results in groups with significant immunocompromise.
authors.affiliation: University of Washington School of Nursing, Box 357266, Seattle, WA 98195-7266, USA. tsimpson@uw.edu
authors.forename: Terri
authors.initials: T
authors.lastname: Simpson
authors.forename: Julie
authors.initials: J
authors.lastname: Tomaro
authors.forename: Cynthia
authors.initials: C
authors.lastname: Jobb
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000554:Ambulatory Care Facilities; D001631:Bhutan; D002648:Child; D002675:Child, Preschool; D054242:Emigrants and Immigrants / Q000706:statistics & numerical data*; D005006:Ethnicity; D005260:Female; D006801:Humans; D059425:Interferon-gamma Release Tests; D055985:Latent Tuberculosis / Q000175:diagnosis* / Q000208:ethnology*; D007988:Liberia; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D002052:Myanmar; D012036:Refugees / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D012307:Risk Factors; D014861:Washington / Q000453:epidemiology