Factors associated with the performance of a blood-based interferon-γ release assay in diagnosing tuberculosis

Banfield, Sally, Pascoe, Elaine, Thambiran, Aesen, Siafarikas, Aris and Burgner, David (2012) Factors associated with the performance of a blood-based interferon-γ release assay in diagnosing tuberculosis. PLoS One, 7 6: e38556.1-e38556.8. doi:10.1371/journal.pone.0038556

Author Banfield, Sally
Pascoe, Elaine
Thambiran, Aesen
Siafarikas, Aris
Burgner, David
Title Factors associated with the performance of a blood-based interferon-γ release assay in diagnosing tuberculosis
Journal name PLoS One   Check publisher's open access policy
ISSN 1932-6203
Publication date 2012-06
Sub-type Article (original research)
DOI 10.1371/journal.pone.0038556
Open Access Status DOI
Volume 7
Issue 6
Start page e38556.1
End page e38556.8
Total pages 8
Place of publication San Francisco, CA, United States
Publisher Public Library of Science
Collection year 2013
Language eng
Formatted abstract
Background: Indeterminate results are a recognised limitation of interferon-γ release assays (IGRA) in the diagnosis of latent tuberculosis (TB) infection (LTBI) and TB disease, especially in children. We investigated whether age and common co-morbidities were associated with IGRA performance in an unselected cohort of resettled refugees.
Methods: A retrospective cross-sectional study of refugees presenting for their post-resettlement health assessment during 2006 and 2007. Refugees were investigated for prevalent infectious diseases, including TB, and for common nutritional deficiencies and haematological abnormalities as part of standard clinical screening protocols. Tuberculosis screening was performed by IGRA; QuantiFERON-TB Gold in 2006 and QuantiFERON-TBGold In-Tube in 2007.
Results: Complete data were available on 1130 refugees, of whom 573 (51%) were children less than 17 years and 1041 (92%) were from sub-Saharan Africa. All individuals were HIV negative. A definitive IGRA result was obtained in 1004 (89%) refugees, 264 (26%) of which were positive; 256 (97%) had LTBI and 8 (3%) had TB disease. An indeterminate IGRA result was obtained in 126 (11%) refugees (all failed positive mitogen control). In multivariate analysis, younger age (linear OR = 0.93 [95% CI 0.91–0.95], P<0.001), iron deficiency anaemia (2.69 [1.51–4.80], P = 0.001), malaria infection (3.04 [1.51–6.09], P = 0.002), and helminth infection (2.26 [1.48–3.46], P<0.001), but not vitamin D deficiency or insufficiency, were associated with an indeterminate IGRA result.
Conclusions: Younger age and a number of common co-morbidities are significantly and independently associated with indeterminate IGRA results in resettled predominantly African refugees.
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ
Additional Notes Article # e38556

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2013 Collection
School of Medicine Publications
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Created: Tue, 26 Jun 2012, 16:07:38 EST by Elaine Pascoe on behalf of Medicine - Princess Alexandra Hospital