Regístrese
Buscar en
Medicina Clínica (English Edition)
Toda la web
Inicio Medicina Clínica (English Edition) Tuberculosis screening programme for undocumented immigrant teenagers using the ...
Journal Information
Vol. 145. Issue 1.
Pages 7-13 (July 2015)
Share
Share
Download PDF
More article options
ePub
Visits
23
Vol. 145. Issue 1.
Pages 7-13 (July 2015)
Original article
DOI: 10.1016/j.medcle.2013.12.003
Tuberculosis screening programme for undocumented immigrant teenagers using the QuantiFERON®-TB Gold In-Tube test
Cribado de la tuberculosis en inmigrantes adolescentes indocumentados usando el QuantiFERON®-TB Gold In-Tube
Visits
23
Carlos Salinasa,
Corresponding author
, Aitor Ballaza, Rosa Díeza, Urko Aguirreb, Ane Antónb, Lander Altubea
a Servicio de Neumología, Hospital de Galdakao-Usansolo, Usansolo, Bizkaia, Spain
b Unidad de Investigación, Hospital de Galdakao-Usansolo, Usansolo, Bizkaia, Spain
This item has received
23
Visits
Article information
Abstract
Full Text
Bibliography
Download PDF
Statistics
Figures (1)
Tables (5)
Table 1. Population characteristics.
Table 2. Kappa coefficients for evaluation of the agreement between the tuberculin skin test and the QuantiFERON®-TB Gold In-Tube assay (n=279).
Table 3. Predictors of a positive TST for various cut-off points for the whole sample of contacts (n=843).
Table 4. Predictors of a positive QFT-GIT result in patients with TST≥5mm (n=279).
Table 5. Predictors of a negative QFT-GIT and positive TST (different cut-off points) with TST≥5mm (n=279).
Show moreShow less
Additional material (1)
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 centres 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 TST5mm.

Results

Eight hundred and forty-five immigrants were included, most of them from Africa (99.5%). Fifty-one percent of immigrants with TST5mm has a positive QFT-GIT. We found 2 cases of active tuberculosis (2/845: 0.24%). The concordance between TST (≥10mm) and QFT-GIT was 63%, with 57% of positive concordance cases and 96% of negative concordances. There were 246 cases with TST10mm (29%), with significant differences between Magrebis (21.5%) and Subsaharians (67%) (p<0.001). Vaccination with Calmette-Guéin bacille was an independent predictor for having a TST10mm (OR: 2.11; p<0.001) and for the discordance TST+/QFT-GIT−, both for a TST5 and a TST10mm (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 analysed: 10–14mm (OR 7.95, 95% CI 1.79–35.33), 15–19mm (OR 35, 95% CI 7.93–154.52) and ≥20mm (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 programmes in this population. Using QFT-GIT, the number of candidates for chemoprophylaxis was reduced to 43% compared with TST alone (≥10mm).

Keywords:
Tuberculin skin test
QuantiFERON® Gold In-Tube
Immigrants
Teenagers
Resumen
Fundamento y objetivo

El objetivo de este estudio fue conocer la prevalencia de la infección tuberculosa en inmigrantes adolescentes indocumentados utilizando una estrategia con la prueba de la tuberculina (PT) para el cribado inicial y el QuantiFERON®-TB Gold In-Tube (QFT-GIT) como prueba confirmativa.

Pacientes y método

Se incluyeron inmigrantes adolescentes recién llegados a 2 centros de alojamiento del País Vasco (España) entre los años 2007 y 2012. La PT se aplicó en todos los participantes, y el QFT-GIT, selectivamente en los reactores con una PT5mm.

Resultados

Completaron el estudio 845 inmigrantes, mayoritariamente africanos (99,5%). Un 51% de los inmigrantes con una PT5mm fue QFT-GIT positivo, que corresponde el 17% de toda la muestra. Se encontraron 2 casos con tuberculosis activa (2/845: 0,24%). La concordancia entre la PT (≥10mm) y el QFT-GIT fue del 63%, con un 57% de resultados concordantes positivos y un 96% de concordantes negativos. Hubo 246 casos con PT10mm (29%), con diferencias significativas entre magrebíes (21,5%) y subsaharianos (67%) (p<0,001). La vacunación con el bacilo Calmette-Guérin fue un predictor independiente de tener una PT10mm (odds ratio [OR] 2,11, p<0,001) y de la discordancia PT+/QFT-GIT−, tanto para una PT5 como para una PT10mm (OR 2,16, intervalo de confianza del 95% [IC 95%] 1,46–3,20, y OR 1,91, IC 95% 1,23–2,97, respectivamente). La proporción de QFT-GIT positivo aumentó significativamente con el incremento de la positividad de la PT, con asociación positiva en todos los tramos analizados: 10–14mm (OR 7,95, IC 95% 1,79–35,33), 15–19mm (OR 35, IC 95% 7,93–154,52) y20mm (OR 91,3, IC 95% 18,20–458,11).

Conclusión

La alta prevalencia de infección tuberculosa latente en los inmigrantes de origen subsahariano hace recomendable la implementación de programas de cribado en esta población. Utilizando el QFT-GIT se redujo en un 43% el número de candidatos a la quimioprofilaxis con arreglo a la PT (10mm).

Palabras clave:
Prueba de la tuberculina
QuantiFERON® Gold In-Tube
Inmigrantes
Adolescentes

Article

These are the options to access the full texts of the publication Medicina Clínica (English Edition)
Subscriber
Subscriber

If you already have your login data, please click here .

If you have forgotten your password you can you can recover it by clicking here and selecting the option “I have forgotten my password”
Subscribe
Subscribe to

Medicina Clínica (English Edition)

Contact
Phone for subscriptions and reporting of errors
From Monday to Friday from 9 a.m. to 6 p.m. (GMT + 1) except for the months of July and August which will be from 9 a.m. to 3 p.m.
Calls from Spain
932 415 960
Calls from outside Spain
+34 932 415 960
E-mail
Article options
Tools
Supplemental materials
es en pt

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?

Você é um profissional de saúde habilitado a prescrever ou dispensar medicamentos

es en pt
Política de cookies Cookies policy Política de cookies
Utilizamos cookies propias y de terceros para mejorar nuestros servicios y mostrarle publicidad relacionada con sus preferencias mediante el análisis de sus hábitos de navegación. Si continua navegando, consideramos que acepta su uso. Puede cambiar la configuración u obtener más información aquí. To improve our services and products, we use "cookies" (own or third parties authorized) to show advertising related to client preferences through the analyses of navigation customer behavior. Continuing navigation will be considered as acceptance of this use. You can change the settings or obtain more information by clicking here. Utilizamos cookies próprios e de terceiros para melhorar nossos serviços e mostrar publicidade relacionada às suas preferências, analisando seus hábitos de navegação. Se continuar a navegar, consideramos que aceita o seu uso. Você pode alterar a configuração ou obter mais informações aqui.