QuantiFERON？-TB Gold In-Tube Performance for Diagnosing Active Tuberculosis in Children and Adults in a High Burden Setting 英文参考文献.docVIP

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QuantiFERON？-TB Gold In-Tube Performance for Diagnosing Active Tuberculosis in Children and Adults in a High Burden Setting 英文参考文献.doc

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QuantiFERON？-TB Gold In-Tube Performance for Diagnosing Active Tuberculosis in Children and Adults in a High Burden Setting 英文参考文献

QuantiFERONH-TBGoldIn-TubePerformancefor DiagnosingActiveTuberculosisinChildrenandAdultsin aHighBurdenSetting MichalaV.Rose1,2*,GodfatherKimaro3,ThomasN.Nissen2,IngeKroidl4,5,MichaelHoelscher5, IbC.Bygbjerg1,SayokiG.Mfinanga3,PernilleRavn6 1DepartmentofInternationalHealth,ImmunologyandMicrobiology,UniversityofCopenhagen,Copenhagen,Denmark,2ClinicalResearchCentre,UniversityHospital Hvidovre,Hvidovre,Denmark,3MuhimbiliMedicalResearchCentre,NationalInstituteforMedicalResearch,DaresSalaam,Tanzania,4NIMR-MbeyaMedicalResearch Programme, Mbeya, Tanzania, 5Department of Infectious Diseases and Tropical Medicine, Klinikum of the University of Munich, Munich, Germany, 6Department for InfectiousDiseases,UniversityHospitalOdense,Odense,Denmark Abstract Aim:TodeterminewhetherQuantiFERONH-TBGoldIn-Tube(QFT)cancontributetothediagnosisofactivetuberculosis(TB) inchildreninahigh-burdensettingandtoassesstheperformanceofQFTandtuberculinskintest(TST)inaprospective cohortofTBsuspectchildrencomparedtoadultswithconfirmedTBinTanzania. Methods:SensitivityandspecificityofQFTandTSTfordiagnosingactiveTBaswellasindeterminateQFTratesandIFN-c levelswereassessedin211TBsuspectchildreninaTanzaniandistricthospitalandcontrastedin90adultswithconfirmed pulmonaryTB. Results: Sensitivity of QFT and TST in children with confirmed TB was 19% (5/27) and 6% (2/31) respectively. In adults sensitivityofQFTandTSTwas84%(73/87)and85%(63/74).TheQFTindeterminaterateinchildrenandadultswas27%and 3%. Median levels of IFN-c were lower in children than adults, particularly children ,2 years and HIV infected. An indeterminateresultwasassociatedwithage,2yearsbutnotmalnutritionorHIVstatus.Overallchildhoodmortalitywas 19%andassociatedwithanindeterminateQFTresultatbaseline. Conclusion: QFT and TST showed poor performance and a surprisingly low sensitivity in children. In contrast the performanceinTanzanianadultswasgoodandcomparabletoperformanceinhigh-incomecountries.Indeterminateresults in children were associated with young