File Download

There are no files associated with this item.

  Links for fulltext
     (May Require Subscription)
Supplementary

Article: T-Spot.TB outperforms tuberculin skin test in predicting development of active tuberculosis among household contacts

TitleT-Spot.TB outperforms tuberculin skin test in predicting development of active tuberculosis among household contacts
Authors
Issue Date2015
PublisherWiley-Blackwell Publishing Asia. The Journal's web site is located at http://www.blackwellpublishing.com/journals/RES
Citation
Respirology, 2015, v. 20 n. 3, p. 496-503 How to Cite?
AbstractBackground and Objective In Hong Kong, neonatal Bacillus Calmette-Guerin (BCG) vaccination is practiced with 99% coverage. This study was to compare the performance of T-Spot.TB and tuberculin skin test (TST) in predicting tuberculosis (TB) among household contacts. Methods From 1 March 2006 to 31 July 2010, 1049 asymptomatic household contacts of smear-positive patients were simultaneously tested with T-Spot.TB and TST, and then followed for up to 5 years for development of TB. Attending clinicians and subjects were blinded to the results of T-Spot.TB. Results T-Spot.TB gave a significantly higher positive rate (32.7% vs 22.1%) and better association with exposure time than TST at the 15 mm cut-off. Agreement between T-Spot.TB and TST using cut-offs of 5, 10 and 15 mm were relatively poor (kappa 0.25-0.41) irrespective of presence or absence of BCG scar. Only T-Spot.TB positivity was negatively associated with BCG scar. Both T-Spot.TB (incidence rate ratio between test-positive and test-negative subjects, IRR: 8.2) and TST (IRR: 4.1, 6.1 and 2.8, using cut-offs of 5 mm, 10 mm and 15 mm, respectively) helped to predict TB. Using a TST cut-off of 15 mm, 56% of future TB cases and 62.5% of bacteriologically confirmed cases were missed. Lowering the TST cut-off to 10 mm or 5 mm could achieve sensitivity comparable with that of T-Spot.TB, but at the expense of lower specificities, with more positive tests (thus requiring treatment) per case of TB predicted. Conclusions T-Spot.TB outperformed TST in predicting TB among household contacts in a high-income area with widespread BCG vaccination coverage. © 2015 Asian Pacific Society of Respirology.
Persistent Identifierhttp://hdl.handle.net/10722/220174
ISSN
2015 Impact Factor: 3.078
2015 SCImago Journal Rankings: 1.157
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorLeung, CC-
dc.contributor.authorYam, WC-
dc.contributor.authorHo, PL-
dc.contributor.authorYew, WW-
dc.contributor.authorChan, CK-
dc.contributor.authorLaw, WS-
dc.contributor.authorLee, SN-
dc.contributor.authorChang, KC-
dc.contributor.authorTai, LB-
dc.contributor.authorTam, CM-
dc.date.accessioned2015-10-16T06:31:35Z-
dc.date.available2015-10-16T06:31:35Z-
dc.date.issued2015-
dc.identifier.citationRespirology, 2015, v. 20 n. 3, p. 496-503-
dc.identifier.issn1323-7799-
dc.identifier.issnWOS:000351175700021-
dc.identifier.urihttp://hdl.handle.net/10722/220174-
dc.description.abstractBackground and Objective In Hong Kong, neonatal Bacillus Calmette-Guerin (BCG) vaccination is practiced with 99% coverage. This study was to compare the performance of T-Spot.TB and tuberculin skin test (TST) in predicting tuberculosis (TB) among household contacts. Methods From 1 March 2006 to 31 July 2010, 1049 asymptomatic household contacts of smear-positive patients were simultaneously tested with T-Spot.TB and TST, and then followed for up to 5 years for development of TB. Attending clinicians and subjects were blinded to the results of T-Spot.TB. Results T-Spot.TB gave a significantly higher positive rate (32.7% vs 22.1%) and better association with exposure time than TST at the 15 mm cut-off. Agreement between T-Spot.TB and TST using cut-offs of 5, 10 and 15 mm were relatively poor (kappa 0.25-0.41) irrespective of presence or absence of BCG scar. Only T-Spot.TB positivity was negatively associated with BCG scar. Both T-Spot.TB (incidence rate ratio between test-positive and test-negative subjects, IRR: 8.2) and TST (IRR: 4.1, 6.1 and 2.8, using cut-offs of 5 mm, 10 mm and 15 mm, respectively) helped to predict TB. Using a TST cut-off of 15 mm, 56% of future TB cases and 62.5% of bacteriologically confirmed cases were missed. Lowering the TST cut-off to 10 mm or 5 mm could achieve sensitivity comparable with that of T-Spot.TB, but at the expense of lower specificities, with more positive tests (thus requiring treatment) per case of TB predicted. Conclusions T-Spot.TB outperformed TST in predicting TB among household contacts in a high-income area with widespread BCG vaccination coverage. © 2015 Asian Pacific Society of Respirology.-
dc.languageeng-
dc.publisherWiley-Blackwell Publishing Asia. The Journal's web site is located at http://www.blackwellpublishing.com/journals/RES-
dc.relation.ispartofRespirology-
dc.titleT-Spot.TB outperforms tuberculin skin test in predicting development of active tuberculosis among household contacts-
dc.typeArticle-
dc.identifier.emailYam, WC: wcyam@hkucc.hku.hk-
dc.identifier.emailHo, PL: plho@hkucc.hku.hk-
dc.identifier.authorityYam, WC=rp00313-
dc.identifier.authorityHo, PL=rp00406-
dc.identifier.doi10.1111/resp.12483-
dc.identifier.pmid25689894-
dc.identifier.scopuseid_2-s2.0-84924577490-
dc.identifier.hkuros255204-
dc.identifier.volume20-
dc.identifier.issue3-
dc.identifier.spage496-
dc.identifier.epage503-
dc.identifier.isiWOS:000351175700021-
dc.publisher.placeAustralia-

Export via OAI-PMH Interface in XML Formats


OR


Export to Other Non-XML Formats