title: [Tuberculosis screening program for undocumented immigrant teenagers using the QuantiFERON(®)-TB Gold In-Tube test].
abstract: OBJECTIVE
  The aim of this study was to determine the prevalence of tuberculosis infection in undocumented immigrant teenagers using a tuberculin skin test (TST) for initial screening and QuantiFERON(®)-TB Gold In-Tube (QFT-GIT) as a confirmatory test.
  
  
  METHODS
  From 2007 to 2012, under 19 year-old immigrant teenagers from 2 accommodation centers of the Basque Country (Spain) were included in the study. The TST was done in all of them and the QFT-GIT was done in selected patients with a TST≥5mm.
  
  
  RESULTS
  Eight hundred and forty-five immigrants were included, most of them from Africa (99.5%). Fifty-one percent of immigrants with TST ≥ 5 mm has a positive QFT-GIT. We found 2 cases of active tuberculosis (2/845: 0.24%). The concordance between TST (≥ 10 mm) and QFT-GIT was 63%, with 57% of positive concordance cases and 96% of negative concordances. There were 246 cases with TST ≥ 10 mm (29%), with significant differences between Magrebis (21.5%) and Subsaharians (67%) (P<.001). Vaccination with Calmette-Guéin bacille was an independent predictor for having a TST ≥ 10 mm (OR: 2.11; P<.001) and for the discordance TST+/QFT-GIT-, both for a TST≥5 and a TST≥10mm (OR 2.16, 95% confidence interval [95% CI] 1.46-3.20, and OR 1.91 95% CI 1.23-2.97, respectively). The positive value of QFT-GIT increased significantly as the TST increased, with a positive association in all the cut-off points analyzed: 10-14 mm (OR 7.95, 95% CI 1.79-35.33), 15-19 mm (OR 35, 95% CI 7.93-154.52) and ≥ 20 mm (OR 91.3, 95% CI 18.20-458.11).
  
  
  CONCLUSIONS
  Due to the high prevalence of latent tuberculosis infection in Subsaharian immigrants, we recommend implementing screening programs in this population. Using QFT-GIT, the number of candidates for chemoprophylaxis was reduced to 43% compared with TST alone (≥ 10 mm).
authors.affiliation: Servicio de Neumología, Hospital de Galdakao-Usansolo, Usansolo, Bizkaia, España. Electronic address: carlos.salinassolano@osakidetza.net.
authors.forename: Carlos
authors.initials: C
authors.lastname: Salinas
authors.affiliation: Servicio de Neumología, Hospital de Galdakao-Usansolo, Usansolo, Bizkaia, España.
authors.forename: Aitor
authors.initials: A
authors.lastname: Ballaz
authors.affiliation: Servicio de Neumología, Hospital de Galdakao-Usansolo, Usansolo, Bizkaia, España.
authors.forename: Rosa
authors.initials: R
authors.lastname: Díez
authors.affiliation: Unidad de Investigación, Hospital de Galdakao-Usansolo, Usansolo, Bizkaia, España.
authors.forename: Urko
authors.initials: U
authors.lastname: Aguirre
authors.affiliation: Unidad de Investigación, Hospital de Galdakao-Usansolo, Usansolo, Bizkaia, España.
authors.forename: Ane
authors.initials: A
authors.lastname: Antón
authors.affiliation: Servicio de Neumología, Hospital de Galdakao-Usansolo, Usansolo, Bizkaia, España.
authors.forename: Lander
authors.initials: L
authors.lastname: Altube
mesh_terms: D000293:Adolescent; D017954:Africa South of the Sahara / Q000208:ethnology; D001500:BCG Vaccine; D003430:Cross-Sectional Studies; D054242:Emigrants and Immigrants / Q000706:statistics & numerical data; D006801:Humans; D007124:Immunoenzyme Techniques; D059425:Interferon-gamma Release Tests; D008297:Male; D008403:Mass Screening / Q000379:methods* / Q000706:statistics & numerical data; D015995:Prevalence; D011446:Prospective Studies; D015203:Reproducibility of Results; D013030:Spain / Q000453:epidemiology; D014374:Tuberculin Test; D014376:Tuberculosis / Q000175:diagnosis* / Q000453:epidemiology / Q000517:prevention & control; D014611:Vaccination / Q000706:statistics & numerical data
chemical_list: D001500:BCG Vaccine
keywords: Adolescentes; Immigrants; Inmigrantes; Prueba de la tuberculina; QuantiFERON(®) Gold In-Tube; Teenagers; Tuberculin skin test