Determining Mycobacterium tuberculosis Infection among BCG-Immunised Ugandan Children by T-SPOT.TB and Tuberculin Skin Testing 英文参考文献.docVIP

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Determining Mycobacterium tuberculosis Infection among BCG-Immunised Ugandan Children by T-SPOT.TB and Tuberculin Skin Testing 英文参考文献.doc

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Determining Mycobacterium tuberculosis Infection among BCG-Immunised Ugandan Children by T-SPOT.TB and Tuberculin Skin Testing 英文参考文献

DeterminingMycobacteriumtuberculosisInfection amongBCG-ImmunisedUgandanChildrenbyT-SPOT.TB andTuberculinSkinTesting GyaviiraNkurunungi1*,JimreevesE.Lutangira1,SwaibA.Lule1,HellenAkurut1,RobertKizindo1, JosephR.Fitchett2,DennisonKizito1,IsmailSebina1,LawrenceMuhangi1,EmilyL.Webb3, StephenCose1,2,AlisonM.Elliott1,2 1Co-infectionStudiesProgramme,MedicalResearchCouncil/UgandaVirusResearchInstituteUgandaResearchUnitonAIDS,Entebbe,Uganda,2DepartmentofClinical Research,LondonSchoolofHygieneandTropicalMedicine,London,UnitedKingdom,3DepartmentofInfectiousDiseaseEpidemiology,LondonSchoolofHygieneand TropicalMedicine,London,UnitedKingdom Abstract Background:Childrenwithlatenttuberculosisinfection(LTBI)representahugereservoirforfuturedisease.Wewishedto determineMycobacteriumtuberculosis(M.tb)infectionprevalenceamongBCG-immunisedfive-year-oldchildreninEntebbe, Uganda,buttherearelimiteddataontheperformanceofimmunoassaysfordiagnosisoftuberculosisinfectioninchildren inendemicsettings.Wethereforeevaluatedagreementbetweenacommercialinterferongammareleaseassay(T-SPOT.TB) and the tuberculin skin test (TST; 2 units RT-23 tuberculin; positive defined as diameter $10mm), along with the reproducibilityofT-SPOT.TBonshort-termfollow-up,inthispopulation. Methodology/PrincipalFindings:Werecruited907childrenofwhich56werehouseholdcontactsofTBpatients.Theywere tested with T-SPOT.TB at age five years and then re-examined with T-SPOT.TB (n=405) and TST (n=319) approximately three weeks later. The principal outcome measures were T-SPOT.TB and TST positivity. At five years, 88 (9.7%) children testedpositivebyT-SPOT.TB.MorethanhalfofthosethatwereT-SPOT.TBpositiveatfiveyearswerenegativeatfollow-up, whereas96%ofbaselinenegativeswereconsistentlynegative.Weobservedsomewhatbetteragreementbetweeninitial andfollow-upT-SPOT.TBresultsamonghouseholdTBcontacts(k=0.77)thanamongnon-contacts(k=0.39).Agreement between T-SPOT.TBandTSTwasweak (k=0.28and k=0.40forT-SPOT.TB at5 yearsandfollow-up,respectively). Of