Abstract
OBJECTIVES:The tuberculin skin test (TST) and the QuantiFERON-TB Gold test (QFT) are used to identify latent tuberculosis infections (LTBIs). The aim of this study was to determine the agreement between these two tests among health care workers in Iran.METHODS:This cross-sectional study included 177 tuberculosis (TB) laboratory staff and 67 non-TB staff. TST indurations of 10 mm or more were considered positive. The Student’s t-test and the chi-square test were used to compare the mean score and proportion of variables between the TB laboratory staff and the non-TB laboratory staff. Kappa statistics were used to evaluate the agreement between these tests, and logistic regression was used to assess the risk factors associated with positive results for each test.RESULTS:The prevalence of LTBIs according to both the QFT and the TST was 17% (95% confidence interval [CI], 12% to 21%) and 16% (95% CI, 11% to 21%), respectively. The agreement between the QFT and the TST was 77.46%, with a kappa of 0.19 (95% CI, 0.04 to 0.34).CONCLUSIONS:Although the prevalence of LTBI based on the QFT and the TST was not significantly different, the kappa statistic was low between these two tests for the detection of LTBIs.
Highlights
The TST is inexpensive and simple, facilitating its use, especially in developing countries, the validity and reliability of the TST is affected by many factors, including Bacillus Calmette-Guérin (BCG) vaccination, infection with non-TB Mycobacterium (NTM) species, the method of TST administration, the interpretation of the reaction, insufficient dosage, and cutaneous anergy [4,5,6,7]
Participants with a history of BCG vaccination were less likely to be QuantiFERON-TB Gold test (QFT)-positive than others (OR, 0.50; 95% confidence intervals (CIs), 0.21 to 1.23) (Table 3)
The results of this study showed that the estimated prevalence of latent tuberculosis infection (LTBI) according to the QFT and the TST was 17% and 16%, respectively.The estimated value of agreement between the QFT and the TST was 77.46%, and the κ statistic was 0.19
Summary
It is estimated that one-third of the world’s population currently has a latent tuberculosis infection (LTBI) as a result of in-. It is estimated that approximately 10% of individuals with an LTBI may develop active tuberculosis (TB) during their lifetime [2]. The timely detection of LTBIs is important to prevent the development of active TB [3]. The tuberculin skin test (TST) is the most commonly used test to identify LTBIs. the TST is inexpensive and simple, facilitating its use, especially in developing countries, the validity and reliability of the TST is affected by many factors, including Bacillus Calmette-Guérin (BCG) vaccination, infection with non-TB Mycobacterium (NTM) species, the method of TST administration, the interpretation of the reaction, insufficient dosage, and cutaneous anergy [4,5,6,7].
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