Comparing an Interferon Gamma Release Assay with the Tuberculin Skin Test During Pregnancy: Implications for Tuberculosis Screening During Prenatal Care

Autor: Nawal M. Nour, Rose L. Molina, Audra R. Meadows, Julianna Schantz-Dunn, Kartik K. Venkatesh, Khady Diouf
Rok vydání: 2015
Předmět:
Adult
medicine.medical_specialty
Tuberculosis
Urban Population
Epidemiology
Memory
Episodic
Concordance
Population
Interferon gamma release assay
Emigrants and Immigrants
Tuberculin
Prenatal care
Sensitivity and Specificity
03 medical and health sciences
0302 clinical medicine
Predictive Value of Tests
Pregnancy
Risk Factors
Prevalence
Humans
Mass Screening
Medicine
030212 general & internal medicine
education
Mass screening
education.field_of_study
030219 obstetrics & reproductive medicine
Latent tuberculosis
Tuberculin Test
business.industry
Obstetrics
Public Health
Environmental and Occupational Health
Obstetrics and Gynecology
Prenatal Care
bacterial infections and mycoses
medicine.disease
Pediatrics
Perinatology and Child Health
Immunology
Female
business
Interferon-gamma Release Tests
Zdroj: Maternal and Child Health Journal. 20:1314-1320
ISSN: 1573-6628
1092-7875
Popis: Background Currently there are no guidelines regarding optimal screening for latent tuberculosis infection during pregnancy. Objective This study measures completion rates and the concordance between the TSPOT.TB, a commercially available interferon gamma release assay (IGRA), and the traditional tuberculin skin test (TST) in a predominantly urban minority obstetrics practice. Design This is an observational cohort study of 141 pregnant women enrolled from an obstetrics practice with a large immigrant population. Women with a history of a positive TST result were excluded. Demographic and clinical risk factors for tuberculosis were assessed. Enrolled women underwent a T-SPOT.TB test and placement of TST, and returned in 48–72 h for TST interpretation. We calculated the completion rate and frequency of a positive result for each test, as well as the concordance between the T-SPOT.TB and TST. Results Among the 141 women enrolled, 75 % were either Latina or African-American, 44 % were born in a country with a high TB prevalence, and 52 % had received the Bacillus Calmette-Guerin vaccine. Seven women (5 %) had a positive screening test, a total of 3 positive T-SPOT.TB results and 6 positive TST results, and all were from countries with a high TB prevalence. The concordance of the two tests was 96.3 %. The completion rate for the T-SPOT.TB was 98 %, while the completion rate for the TST was 63 %. Conclusion: The IGRA test had a markedly higher completion rate in addition to maintaining high concordance with the two-step TST in this population of pregnant women with a high prevalence of prior TB exposure. Targeted screening of women from countries with a high prevalence of tuberculosis may be warranted during prenatal care.
Databáze: OpenAIRE
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