Potential effect of NICE tuberculosis guidelines on paediatric tuberculosis screening

Taylor, R. E. B., Cant, A. J. and Clark, J. E. (2008) Potential effect of NICE tuberculosis guidelines on paediatric tuberculosis screening. Archives of Disease in Childhood, 93 3: 200-203. doi:10.1136/adc.2006.106617

Author Taylor, R. E. B.
Cant, A. J.
Clark, J. E.
Title Potential effect of NICE tuberculosis guidelines on paediatric tuberculosis screening
Journal name Archives of Disease in Childhood   Check publisher's open access policy
ISSN 0003-9888
Publication date 2008-03
Year available 2007
Sub-type Article (original research)
DOI 10.1136/adc.2006.106617
Open Access Status Not yet assessed
Volume 93
Issue 3
Start page 200
End page 203
Total pages 4
Place of publication London, United Kingdom
Publisher B M J Group
Language eng
Formatted abstract
Objective: Assays based on interferon γ (IFNγ) are an exciting new development for screening for latent tuberculosis infection (LTBI) in adults, but there are limited data on their effectiveness in children. Nevertheless new National Institute for Health and Clinical Excellence (NICE) guidelines recommend their use when screening paediatric tuberculosis (TB) contacts. We evaluated the potential effect of the new NICE guidelines on current paediatric practice.

Design: Children screened for TB who had had an IFNγ assay performed (QuantiFERON-TB Gold (QFG)) were included. Actual outcomes from existing guidelines were compared with those that would have been obtained using NICE guidelines.

Results: QFG assays were performed on 120 children, 103 as part of TB contact tracing. Six of the 120 (5%) were QFG positive, and seven of the 120 (6%) were indeterminate. Where both Mantoux and QFG results were available, these agreed in 62/104 (60%) of cases. QFG tests were more likely to correlate with a negative Mantoux (98% agreement) than with a positive Mantoux (11% agreement). Management outcomes differed for 23/ 103 children seen as part of TB contact tracing. Only one (1%) of these had an indeterminate QFG result. 17 (85%) fewer children would have been given LTBI treatment (chemoprophylaxis) and two (2%) children with possible TB would not have been identified using NICE guidelines.

Conclusion: New NICE guidelines for the use of IFNγ-based tests for TB screening will reduce the number of children treated for presumed LTBI. Long-term prospective studies are needed to determine the number of children with positive Mantoux tests but negative IFNγ results who are not given LTBI treatment yet later develop TB.
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collection: School of Medicine Publications
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Citation counts: TR Web of Science Citation Count  Cited 17 times in Thomson Reuters Web of Science Article | Citations
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