QuantiFERON Gold-In-Tube for the Diagnosis of Mycobacterial Tuberculosis Infection in Children Under 5 Years of Age: A Systematic Review and Meta-analysis

Overview

Journal PLoS One

Specialties General Medicine
Science

Date 2024 Jan 2

PMID 38166111

Authors

Thomas Volkman

Visai Muruganandah

Hamish Graham

Shidan Tosif

Simon Stokes

Sarath Ranganathan

Affiliations

Soon will be listed here.

Abstract

Background: Previous meta-analysis regarding the performance of QuantiFERON Gold-In-Tube in children have yielded contrasting results. Emerging data in children younger than 5 years of age necessitates a new analysis.

Methods: Systematic searches were conducted of MedLINE, EMBASE and Cochrane databases between 1998-2023. Pooled estimates of sensitivities and specificities of QFT-GIT compared to tuberculin skin test (TST) were calculated. The Kappa (k) coefficient was calculated for each study to determine the degree of congruence between TST and QFT-GIT results. Studies including patients co-infected with HIV or other immune compromising conditions or those treated with anti-tubercular treatment were excluded.

Results: Seventeen studies (4335 patients) were included in quantitative analysis. All studies were conducted in middle to high income countries. They were conducted across 14 countries and 4 studies in countries with high TB incidence. The pooled sensitivity, specificity and DOR were 0.45 (0.42-0.48), 0.96 (0.96-0.97) and 18.84 (7.33-48.41) respectively. The ability of QFT-GIT to discriminate with disease and no disease was "good" as demonstrated by a summary receiver operating characteristic curve with area under curve of 0.7812. The average Kappa (k) co-efficient was 0.501 with a wide variety of values between studies (0.167 to 0.800).

Conclusion: The findings of this meta-analysis support the judicious use of QFT-GIT in children 5 years and under, with caution as a sole test to exclude Tuberculosis in this age group. The heterogeneity and methodological quality of diagnostic studies limits the generalisability of results.

Citing Articles

Interferon-Gamma Release Assay Testing for Latent Tuberculosis Infection: A Health Technology Assessment.

Ont Health Technol Assess Ser. 2025; 24(11):1-183.

PMID: 39911267 PMC: 11792883.

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