Combination of serological and cytokine release assays for improved diagnosis of childhood tuberculosis in Zambia (PROMISE-TB).

Autor:	Tuaillon E; Pathogenesis and Control of Chronic and Emerging Infections, Université de Montpellier, Inserm, Etablissement Français du Sang, Université des Antilles, Montpellier, France; University Hospital of Montpellier, Montpellier, France. Electronic address: e-tuaillon@chu-montpellier.fr., Mwyia M; Pediatric Center of Excellence, University Teaching Hospital, Lusaka, Zambia., Bollore K; Pathogenesis and Control of Chronic and Emerging Infections, Université de Montpellier, Inserm, Etablissement Français du Sang, Université des Antilles, Montpellier, France., Pisoni A; Pathogenesis and Control of Chronic and Emerging Infections, Université de Montpellier, Inserm, Etablissement Français du Sang, Université des Antilles, Montpellier, France; University Hospital of Montpellier, Montpellier, France., Rubbo PA; Pathogenesis and Control of Chronic and Emerging Infections, Université de Montpellier, Inserm, Etablissement Français du Sang, Université des Antilles, Montpellier, France; University Hospital of Montpellier, Montpellier, France., Richard M; Centre National de la Recherche Scientifique UMR 9004, Institut de Recherche en Infectiologie de Montpellier (IRIM), Université de Montpellier, Montpellier, France., Kremer L; Centre National de la Recherche Scientifique UMR 9004, Institut de Recherche en Infectiologie de Montpellier (IRIM), Université de Montpellier, Montpellier, France., Tonga MMW; Pediatric Center of Excellence, University Teaching Hospital, Lusaka, Zambia., Chanda D; Pediatric Center of Excellence, University Teaching Hospital, Lusaka, Zambia., Peries M; Pathogenesis and Control of Chronic and Emerging Infections, Université de Montpellier, Inserm, Etablissement Français du Sang, Université des Antilles, Montpellier, France., Vallo R; Pathogenesis and Control of Chronic and Emerging Infections, Université de Montpellier, Inserm, Etablissement Français du Sang, Université des Antilles, Montpellier, France., Eymard-Duvernay S; Pathogenesis and Control of Chronic and Emerging Infections, Université de Montpellier, Inserm, Etablissement Français du Sang, Université des Antilles, Montpellier, France., D'Ottavi M; Pathogenesis and Control of Chronic and Emerging Infections, Université de Montpellier, Inserm, Etablissement Français du Sang, Université des Antilles, Montpellier, France., Kankasa C; Pediatric Center of Excellence, University Teaching Hospital, Lusaka, Zambia., de Perre PV; Pathogenesis and Control of Chronic and Emerging Infections, Université de Montpellier, Inserm, Etablissement Français du Sang, Université des Antilles, Montpellier, France; University Hospital of Montpellier, Montpellier, France., Moles JP; Pathogenesis and Control of Chronic and Emerging Infections, Université de Montpellier, Inserm, Etablissement Français du Sang, Université des Antilles, Montpellier, France., Nagot N; Pathogenesis and Control of Chronic and Emerging Infections, Université de Montpellier, Inserm, Etablissement Français du Sang, Université des Antilles, Montpellier, France; University Hospital of Montpellier, Montpellier, France.
Jazyk:	angličtina
Zdroj:	International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases [Int J Infect Dis] 2024 Nov; Vol. 148, pp. 107248. Date of Electronic Publication: 2024 Sep 26.
DOI:	10.1016/j.ijid.2024.107248
Abstrakt:	Objectives: The diagnostic gaps for childhood tuberculosis (TB) remain considerable in settings with high TB incidence and resource constraints. We established and evaluated the performance of a scoring system based on a combination of serological tests and T-cell cytokine release assays, chosen for their ability to detect immune responses indicative of TB, in a context of high prevalence of pediatric HIV infection. Methods: We enrolled 628 consecutive children aged ≤15 years, admitted for TB suspicion. Multiple cytokine levels in QuantiFERON Gold In-Tube supernatants and antigen 85B (Ag85B) antibodies were assessed in children who tested positive with either Xpert TB or mycobacterial culture. The results were compared with those of control children. Results: Among the biomarkers most strongly associated with TB, random forest classification analysis selected Ag85B antibodies, interleukin-2/interferon-γ ratio, and monokine induced by interferon-γ for the scoring system. The receiver operating characteristic curve derived from our scoring system showed an area under the curve of 0.95 (0.91-0.99), yielding 91% sensitivity and 88% specificity. The internal bootstrap validation gave the following 95% confidence intervals for the score performance: sensitivity 71%-97% and specificity 79%-99%. Conclusions: This study suggests that supplementing the QuantiFERON assay with a combination of serological and T-cell markers could enhance childhood TB screening regardless of HIV status and age. Further validation among the target population is necessary to confirm the performance of this scoring system. Competing Interests: Declarations of competing interest The authors have no competing interests to declare. (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)
Databáze:	MEDLINE
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