How Well Does TSTin3D Predict Risk of Active Tuberculosis in the Canadian Immigrant Population? An External Validation Study

Abstract Background The online Tuberculin Skin Test/Interferon Gamma Release Assay (TST/IGRA) Interpreter V3.0 (TSTin3D), a tool for estimating the risk of active tuberculosis (TB) in individuals with latent TB infection (LTBI), has been in use for more than a decade, but its predictive performance has never been evaluated. Methods People with a positive TST or IGRA result from 1985 to 2015 were identified using a health data linkage that involved migrants to British Columbia, Canada. Comorbid conditions at the time of LTBI testing were identified from physician claims, hospitalizations, vital statistics, outpatient prescriptions, and kidney and HIV databases. The risk of developing active TB within 2 and 5 years was estimated using TSTin3D. The discrimination and calibration of these estimates were evaluated. Results A total of 37 163 individuals met study inclusion criteria; 10.4% were tested by IGRA. Generally, the TSTin3D algorithm assigned higher risks to demographic and clinical groups known to have higher active TB risks. Concordance estimates ranged from 0.66 to 0.68 in 2- and 5-year time frames. Comparing predicted to observed counts suggests that TSTin3D overestimates active TB risks and that overestimation increases over time (with relative bias of 3% and 12% in 2- and 5-year periods, respectively). Calibration plots also suggest that overestimation increases toward the upper end of the risk spectrum. Conclusions TSTin3D can discriminate adequately between people who developed and did not develop active TB in this linked database of migrants with predominately positive skin tests. Further work is needed to improve TSTin3D’s calibration.

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Surveillance of Employees of Swiss Federal Asylum Centres for Latent Tuberculosis Infection

Respiration ◽

10.1159/000514110 ◽

2021 ◽

pp. 369-373

Author(s):

Jean-Pierre Zellweger ◽

Ariane Zellweger-Landry ◽

Jean-Marie Egger ◽

Annette Koller-Doser ◽

Axel Jeremias Schmidt

Keyword(s):

Asylum Seekers ◽

Latent Tuberculosis Infection ◽

Latent Tuberculosis ◽

Active Tuberculosis ◽

Interferon Gamma Release Assay ◽

Work Related ◽

Release Assay ◽

Latent Tb ◽

Latent Tb Infection

Background: Asylum seekers in Switzerland have to register in federal asylum centres (FACs) before formal permission to enter the country. Some of them may have active tuberculosis (TB), exposing fellow refugees and employees. Objectives: The aim of this study was to assess the risk of TB infection among employees of Swiss FACs. Methods: Between 2010 and 2018, a free interferon-gamma release assay (IGRA) was offered to all employees of 8 FACs, at employment and at yearly intervals. We defined latent TB infection as IGRA conversion from negative to positive. IGRA-positive employees were referred to a medical centre for further clinical follow-up. Results: 1,427 tests were performed among 737 employees (54.6% male). 403 (55%) persons were tested only once; 330 (44.5%) were tested several times; for 4 (0.5%) persons, the number of IGRA tests is unknown. Twenty employees (2.7%) had a positive IGRA at baseline, 2 (0.6%) converted from negative to positive during follow-up, resulting in an incidence of 22/10,000 person-years. We observed no case of active TB among employees. Conclusions: The prevalence of latent TB among employees to Swiss FACs and the risk of acquiring TB infection through work-related exposure are low. Yearly IGRA controls in the absence of documented TB exposure seem unnecessary.

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Efficiency of the Interferon-Gamma Release Assay T-spot^|^reg;.TB on the diagnosis of active tuberculosis in a patient receiving maintenance hemodialysis

Nihon Toseki Igakkai Zasshi ◽

10.4009/jsdt.46.681 ◽

2013 ◽

Vol 46 (7) ◽

pp. 681-686

Author(s):

Ryo Koda ◽

Atsunori Yoshino ◽

Yuji Imanishi ◽

Shinya Kawamoto ◽

Tetsuro Takeda ◽

...

Keyword(s):

Interferon Gamma ◽

Active Tuberculosis ◽

Maintenance Hemodialysis ◽

Interferon Gamma Release Assay ◽

Release Assay

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Serial T-SPOT.TB in household contacts of tuberculosis patients: a 6-year observational study in China

The International Journal of Tuberculosis and Lung Disease ◽

10.5588/ijtld.18.0252 ◽

2019 ◽

Vol 23 (9) ◽

pp. 989-995 ◽

Cited By ~ 3

Author(s):

H-C. Zhang ◽

Q-L. Ruan ◽

J. Wu ◽

S. Zhang ◽

S-L. Yu ◽

...

Keyword(s):

Observational Study ◽

Preventive Treatment ◽

Preventive Therapy ◽

Interferon Gamma Release Assay ◽

Household Contacts ◽

Conversion Rates ◽

Ltbi Prevalence ◽

Release Assay ◽

Latent Tb Infection

BACKGROUND: Screening tuberculosis (TB) contacts is a priority for TB control; however, it remains inadequate in most regions of China.OBJECTIVE: To investigate the progression of latent TB infection (LTBI) using the interferon-gamma release assay (IGRA) in contacts of active TB patients.DESIGN: This longitudinal prospective observational study included 159 household contacts aged ≥14 years without preventive treatment who were followed up for 6 years to compare their conversion and reversion rates using the T-SPOT®.TB IGRA to diagnose LTBI.RESULTS: Among the 159 household contacts, LTBI positivity was 47.5%. Age was independently associated with LTBI (OR 3.6, 95%CI 1.81–7.14; P = 0.00). T-SPOT.TB conversion rates were respectively 29.4% and 18.8% at 3- and 6-year follow-up. The reversion rates were 9.4% of contacts during the 3-year follow-up period, which increased to 38.2% at the 6-year follow-up. A decreasing trend in spot-forming cells on T-SPOT.TB was observed in most patients at the 6-year follow-up.CONCLUSION: LTBI prevalence among household contacts was relatively high, particularly in elderly patients. Furthermore, serial IGRA testing was highly dynamic; however, this overall trend gradually decreased over time, even if preventive therapy was not prescribed.

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Negative Tuberculin Skin Test and Prediction of Reversion of QuantiFERON Interferon Gamma Release Assay in US Healthcare Workers

Infection Control and Hospital Epidemiology ◽

10.1017/ice.2015.324 ◽

2016 ◽

Vol 37 (4) ◽

pp. 478-482 ◽

Cited By ~ 4

Author(s):

Wendy Thanassi ◽

Art Noda ◽

Beatriz Hernandez ◽

Leah Friedman ◽

Susan Dorman ◽

...

Keyword(s):

Tuberculin Skin Test ◽

Skin Test ◽

Interferon Gamma ◽

Healthcare Workers ◽

Low Risk ◽

Infect Control Hosp ◽

Skin Tests ◽

Interferon Gamma Release Assay ◽

Negative Tuberculin Skin Test ◽

Release Assay

QuantiFERON tuberculosis tests (QFT) reverted in (612) 77% of 1,094 low-risk healthcare workers (HCW) testing less than 1.16 IU/mL. Of HCW testing greater than 1.1 IU/mL, 33 (59%) of 56 with negative tuberculin skin tests (TST) reverted vs 8 (6%) of 125 with positive TSTs. Retesting low-risk QFT-positive and TST-negative HCW is prudent.Infect. Control Hosp. Epidemiol. 2016;37(4):478–482

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Tuberculosis Screening for People With Chronic Conditions

Canadian Journal of Health Technologies ◽

10.51731/cjht.2021.70 ◽

2021 ◽

Vol 1 (5) ◽

Author(s):

Kendra Brett ◽

Melissa Severn

Keyword(s):

Immune System ◽

Interferon Gamma ◽

Chronic Conditions ◽

Active Tuberculosis ◽

Tuberculosis Infection ◽

Interferon Gamma Release Assay ◽

People Living With Hiv ◽

Solid Organ ◽

Cell Transplant ◽

Release Assay

Five guidelines were identified that provide recommendations about screening for tuberculosis in people with chronic conditions. These guidelines cover populations with HIV, psoriasis vulgaris, solid organ and stem transplants, chronic inflammation, and compromised immune systems. Three guidelines recommend regularly screening for latent and active tuberculosis in people diagnosed with HIV or those taking medication that suppresses their immune system. One guideline for patients with psoriasis recommends using interferon-gamma release assay and a chest X-ray to rule out tuberculosis infection before immunosuppressant treatment is initiated and during treatment. Two guidelines recommend using both the interferon-gamma release assay and the tuberculin skin test at the same time to screen for latent tuberculosis infection in people with HIV, people with or who need an organ or stem cell transplant, and in people taking medication that suppresses their immune system. One guideline for people living with HIV recommends using a rapid nucleic acid amplification test to confirm clinical suspicions of active tuberculosis in these patients.

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Interferon Gamma Release Assay After BCG Vaccination Among Newborns and Family Members Living in an Overcrowded Area in Jakarta, Indonesia

10.21203/rs.3.rs-96905/v1 ◽

2020 ◽

Author(s):

Francisca Srioetami Tanoerahar ◽

Indri Rooslamiati ◽

Natalie Kipuw ◽

Hadiyanto ◽

Soegianto Ali ◽

...

Keyword(s):

Interferon Gamma ◽

Family Members ◽

Latent Tuberculosis ◽

Interferon Gamma Release Assay ◽

Pulmonary Tb ◽

Bcg Vaccination ◽

Release Assay ◽

Latent Tb ◽

Poor Area ◽

Latent Tb Infection

Abstract IntroductionActive tuberculosis (TB) patient is a potential source of Mycobacterium tuberculosis transmission in an overcrowded and poor area. Family members living in the same house may have been infected or latent tuberculosis infection (LTBI) may develop. The aim of the study was to explore LTBI among newborns and their family members living in an overcrowded area in Jakarta, Indonesia. MethodsA prospective analytical study was conducted among newborns from October 2016 to March 2017. Interferon gamma release assay (IGRA) was examined before BCG vaccination and after 12 weeks. In parallel, TB active case finding was performed among family members of the newborns.ResultsOf 135 newborns, only 117 (86.7%) came for BCG vaccination. Of 346 family members screened, 8 (2.3%) were detected as untreated active pulmonary TB, confirmed by positive sputum and/or MTB culture. Family members living in the same house with active TB individuals (p=0.011, OR 2.69) as well as being males (p = 0.025; OR 1.68) had a significant higher risk of having a positive IGRA. ConclusionsUntreated pulmonary TB infection in overcrowded areas infects the surrounding neighbors, resulting in latent TB infection. An active program for detecting pulmonary TB cases and preventive measures need to be taken seriously to contain the potential spreading of the infection.

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Comparison of interferon gamma release assay & tuberculin skin tests for diagnosis of latent tuberculosis in patients on maintenance haemodialysis

The Indian Journal of Medical Research ◽

10.4103/0971-5916.159297 ◽

2015 ◽

Vol 141 (4) ◽

pp. 463 ◽

Cited By ~ 5

Author(s):

SanjayK Agarwal ◽

UrvashiB Singh ◽

SabahatH Zaidi ◽

Sanjay Gupta ◽

RavinderM Pandey

Keyword(s):

Interferon Gamma ◽

Latent Tuberculosis ◽

Skin Tests ◽

Interferon Gamma Release Assay ◽

Maintenance Haemodialysis ◽

Release Assay

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High tuberculosis incidence among people living with diabetes in Indonesia

Transactions of the Royal Society of Tropical Medicine and Hygiene ◽

10.1093/trstmh/trz100 ◽

2019 ◽

Cited By ~ 1

Author(s):

Susan M McAllister ◽

Raspati C Koesoemadinata ◽

Prayudi Santoso ◽

Nanny N M Soetedjo ◽

Abdul Kamil ◽

...

Keyword(s):

Incidence Rate ◽

Preventive Therapy ◽

Incidence Rates ◽

Urban Setting ◽

Sputum Smear ◽

Interferon Gamma Release Assay ◽

Release Assay ◽

Chest X Ray ◽

Latent Tb ◽

Latent Tb Infection

Abstract Background Data regarding the incidence of tuberculosis (TB) among people living with diabetes (PLWD) in TB-endemic settings are scarce. We examined TB incidence among PLWD in Indonesia who had previously been screened for latent TB infection (LTBI) and TB disease. Methods PLWD (≥18 y of age) in an urban setting were examined a mean 3.4 y after they had been screened for active TB and LTBI. Data on subsequent TB diagnosis were collected by interview and with chest X-ray, sputum smear and Mycobacterium tuberculosis culture. TB incidence rates were stratified for baseline LTBI status, as determined by the QuantiFERON interferon-gamma release assay (IGRA). Results Of 590 PLWD, 101 had died and 163 could not be contacted or refused. Among the 326 who were re-examined, 6 (1.8%; 95% confidence interval [CI] 0.7 to 4.0) reported being diagnosed already and a further 5 were diagnosed with active TB (1.5%; 95% CI 0.50 to 3.5). The TB incidence rate was 9.85 (95% CI 4.03 to 15.68) per 1000 person-years. TB incidence was higher among PLWD with baseline LTBI (17.13; 95% CI 5.25 to 29.00/1000 person-years) compared with those without LTBI (4.79; 95% CI −0.63 to 10.21), with an incidence rate ratio of 3.57 (95% CI 0.86 to 20.92; p=0.054). Conclusions PLWD with LTBI in Indonesia and similar settings are likely to benefit from TB preventive therapy.

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