No added value of interferon-γ release to a prediction model for childhood tuberculosis.

Autor:	Togun TO; Vaccines and Immunity Theme, Medical Research Council (MRC) Unit, Banjul, The Gambia ttogun@mrc.gm., Egere U; Vaccines and Immunity Theme, Medical Research Council (MRC) Unit, Banjul, The Gambia., Gomez MP; Vaccines and Immunity Theme, Medical Research Council (MRC) Unit, Banjul, The Gambia., Sillah AK; Vaccines and Immunity Theme, Medical Research Council (MRC) Unit, Banjul, The Gambia., Daramy M; Vaccines and Immunity Theme, Medical Research Council (MRC) Unit, Banjul, The Gambia., Tientcheu LD; Vaccines and Immunity Theme, Medical Research Council (MRC) Unit, Banjul, The Gambia., S Sutherland J; Vaccines and Immunity Theme, Medical Research Council (MRC) Unit, Banjul, The Gambia., Hill PC; Centre for International Health and the Otago International Health Research Network, Dept of Preventive and Social Medicine, University of Otago School of Medicine, Dunedin, New Zealand., Kampmann B; Vaccines and Immunity Theme, Medical Research Council (MRC) Unit, Banjul, The Gambia Academic Dept of Paediatrics, Imperial College London, London, UK.
Jazyk:	angličtina
Zdroj:	The European respiratory journal [Eur Respir J] 2016 Jan; Vol. 47 (1), pp. 223-32. Date of Electronic Publication: 2015 Oct 22.
DOI:	10.1183/13993003.00890-2015
Abstrakt:	The predictive value of a combination of clinical and radiological features with interferon-γ release assay (IGRA) for diagnosis of active tuberculosis (TB) disease among TB-exposed children is unknown.150 symptomatic HIV-negative children (aged 3 months to 14 years), prospectively recruited through active contact tracing, were included. Backward stepwise logistic regression and bootstrapping techniques were used for the development and internal validation of a clinical prediction model for active TB disease. Model discrimination and incremental value of a positive IGRA test were assessed by area under the receiver operating characteristic curve (AUC).35 (23%) children were diagnosed with active TB disease and started on treatment and 115 (77%) had other respiratory tract infections. A final parsimonious clinical model, comprising age <5 years (adjusted (a)OR 4.8, 95% CI 2.0-11.5) and lymphadenopathy on clinical examination (aOR 4.9, 95% CI 1.8-13.0) discriminated active TB disease from other disease with an AUC of 0.70 (95% CI 0.61-0.80). A positive IGRA result did not improve the discriminatory ability of the clinical model (c-statistic 0.72 versus 0.70; p=0.644).A clinical algorithm, including age <5 years and lymphadenopathy classified 70% of active TB disease among symptomatic TB-exposed children. IGRA does not add any discriminatory value to this prediction model. (Copyright ©ERS 2016.)
Databáze:	MEDLINE
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