Salinas C, Ballaz A, Díez R, Aguirre U, Antón A, Altube L. [Tuberculosis screening program for undocumented immigrant teenagers using the QuantiFERON(®)-TB Gold In-Tube test].
Med Clin (Barc) 2014;
145:7-13. [PMID:
24747025 DOI:
10.1016/j.medcli.2013.12.017]
[Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2013] [Revised: 12/18/2013] [Accepted: 12/18/2013] [Indexed: 10/25/2022]
Abstract
BACKGROUND AND 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.
PATIENT AND METHOD
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).
CONCLUSION
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).
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