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THE COMPARISON OF TUBERCULIN SKIN TEST AND QUANTIFERON-TB GOLD TEST FOR THE DETERMINATION OF LATENT TUBERCULOSIS INFECTION IN HEALTHCARE WORKERS IN A PULMONARY DISEASES HOSPITAL
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Derya Yenibertiz *   , Melike Demir , Dilek Kanmaz , Esin Tuncay |
| Department of Chest Disease, Yedikule Chest Disease and Thoracic Surgery Training and Research Hospital, 34020 Zeytinburnu/ Istanbul, Turkey |
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Abstract: (11393 Views) |
| To evaluate the positivity rate and effectiveness of tuberculin skin test (TST) and Quantiferon-TB Gold test (QFT) in the diagnosis of latent tuberculosis infection in healthcare workers (HCWs) and the parameters that affect the the results of those tests.
Healthcare workers from tertiary care pulmonary diseases hospital were enrolled into the study. BCG scars were evaluated and chest roentgenograms were obtained. TST was applied by the Mantoux method to the participants and the diameters of induration above 15 mm with BCG scars and above 10 mm without BCG scars were considered as positive. On the day of TST, blood sample was taken for QFT which measures interferon gama levels associated with specific antigens such as ESAT-6, CFP-10, and antigen 7.7. The tuberculosis specific antigen-Nil value of 0.35≥IU/ml was accepted as positive QFT and <0.35 IU/ml was recorded as negative QFT.
Ninety-four HCWs were included. The mean age of the participants was 32.6±9.4 years. Fifty-nine of them were women (62.8%) and 35 were men (37.2%). Thirty (31.9%) of HCWs were doctors, 27 (28.7%) were nurses, and 37 (39.4%) were allied health personal. The positivity of TST and QFT increased significantly with aging (p:0.026 and 0.002, respectively). It was found by univariate analysis that the positivity of QFT was affected from age and working duration but multivariate analysis revealed that the working duration was the only independent risk factor affecting the positivity of QFT (p:0.018). A statistically significant correlation was determined between the positivities of TST or QFT and induration diameter (p<0.001). TST and QFT were determined positive in 59 (62.8%) and 51 (54.3%) of the participants, respectively. Low level of agreement was detected between two tests (69.8%, k:0.391).
Quantiferon-TB Gold test was found to be more effective and sensitive in relation to TST for the diagnosis of latent infection in the BCG-vaccinated people. We think that Int j med invest.2(3):166-175 October 2013
167 International journal of medical investigation www.intjmi.com
QFT should be used instead of TST for screening latent infection in the HCWs, in the populations with high prevalence of tuberculosis and routine BCG vaccination alike our country. |
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| Keywords: Tuberculin skin test, QuantiFERON-TB Gold test, Latent tuberculosis infection, Healthcare workers |
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Full-Text [PDF 759 kb]
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Type of Study: Research |
Subject:
General
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