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dc.contributor.authorJenum, Synneen_US
dc.contributor.authorSelvam, Sumithraen_US
dc.contributor.authorMahelai, Dianaen_US
dc.contributor.authorJesuraj, Nelsonen_US
dc.contributor.authorCardenas, Vickyen_US
dc.contributor.authorKenneth, Johnen_US
dc.contributor.authorHesseling, Anneke C.en_US
dc.contributor.authorDoherty, Tanya Marken_US
dc.contributor.authorVaz, Marioen_US
dc.contributor.authorGrewal, Harleenen_US
dc.description.abstractBackground: Reliable identification of Mycobacterium tuberculosis infection or tuberculosis (TB) disease in young children is vital to assure adequate preventive and curative treatment. The tuberculin skin test (TST) and IFNγ-release assays may supplement the diagnosis of pediatric TB as cases are typically bacteriologically unconfirmed. However, it is unclear to what extent the performance of TST and QuantiFERON-TB Gold In-Tube (QFT; Cellestis’ IFNγ-release assay test) depends on the demographic, clinical and nutritional characteristics of children in whom they are tested. Methods: During a 2-year prospective observational study of 4382 neonates in Southern India, children with suspected TB were investigated and classified by a standard TB diagnostic algorithm. Results: Clinical TB was diagnosed in 13 of 705 children referred for case verification with suspected TB. TST and QFT had a susceptibility for clinical TB of 31% and 23%, respectively, in this group. Children <2 years were more likely to test QFT indeterminate. A height-for-age Z score within the lowest quartile increased the odds ratio (OR) for a positive or indeterminate QFT result [OR 2.46 (1.19–5.06), OR 3.08 (1.10–8.58)], whereas the OR for a positive TST was reduced with a weight-for-height Z score within the lowest quartile [OR 0.17 (0.06–0.47)]. Conclusion: The sensitivities of the TST and QFT for clinical TB in children <3 years of age were equally poor in this population. Stunted children were more susceptible to Mycobacterium tuberculosis infection and more prone to indeterminate QFT results. TST was less reliable in children with wasting.en_US
dc.publisherLippincott, Williams & Wilkinseng
dc.rightsAttribution-NonCommercial-NoDerivs CC BY-NC-NDeng
dc.subjectTuberculin skin testeng
dc.subjectInterferon-gamma release assayeng
dc.subjectmultivariate analyseseng
dc.titleInfluence of Age and Nutritional Status on the Performance of the Tuberculin Skin Test and QuantiFERON®-TB Gold In-Tube in Young Children Evaluated for Tuberculosis in Southern India.en_US
dc.typePeer reviewed
dc.typeJournal article
dc.rights.holderCopyright 2014 Lippincott Williams & Wilkins
dc.source.journalThe Pediatric Infectious Disease Journal

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