Devasahayam J. Christopher , N. Priya , Deepa Shankar , Barney Isaac , Andrea DeLuca , Sonali Sarkar , Senbagavalli Prakash Babu , Prasanna Samuel , Adithya Cattamanchi , Amita Gupta , Jerrold Ellner , Sudha Srinivasan , Samyra Cox , Balamugesh Thangakunam
{"title":"使用印度本土纯化蛋白衍生物(PPD)进行的结核菌素测试与国际标准 PPD 的一致性仅为中等水平","authors":"Devasahayam J. Christopher , N. Priya , Deepa Shankar , Barney Isaac , Andrea DeLuca , Sonali Sarkar , Senbagavalli Prakash Babu , Prasanna Samuel , Adithya Cattamanchi , Amita Gupta , Jerrold Ellner , Sudha Srinivasan , Samyra Cox , Balamugesh Thangakunam","doi":"10.1016/j.jctube.2023.100404","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><p>In India, the prevalence of Latent TB infection (LTBI) is estimated to be around 40%. Various formulations of PPD(Purified protein derivative) are available, for diagnosis of LTBI, which may give variable responses. The commercially available PPD in India is by Arkray Healthcare (TST-Arkray). It is unclear if this product may have a similar sensitivity compared to other internationally accepted tuberculins (TST-Tubersol).</p></div><div><h3>Objectives</h3><p>To assess the performance of the two TSTs compared to Quantiferon-Gold Plus (QFT-Plus).</p></div><div><h3>Methodology</h3><p>A blood sample was collected for the QFT-Plus test. Both the TSTs were placed in the right and the left volar aspect of the forearms and 48 hrs later, the subjects came back to the study site for reading.</p></div><div><h3>Results</h3><p>Among the 512 participants who were recruited, 326 subjects were healthcare professionals and 186 subjects were household contacts of patients with tuberculosis. They were tested with both TST-Tubersol and TST-Arkray, 139(27 %) participants tested positive for TST-Tubersol (≥10 mm), whereas 203 participants (40.1 %)tested positive for TST-Arkray. There was moderate agreement between the two tests with k = 0.58. Also, there was only poor agreement between both the TSTs with QFT Plus(kappa = 0.19 for Tubersol and 0.17 for Arkray). With QFT-Plus as gold standard, the sensitivity, specificity, PPV and NPV of TST-Tubersol, ast an induration cut-off of 10 mm was 46.8 %,76.3 %,31.8 % and 85.8 %. respectively and TST- Arkray; 60.6 %, 64 %, 28.5 % and 87.2 % respectively.</p></div><div><h3>Conclusion</h3><p>The Indian TST (Arkray Diagnostics) has shown moderate agreement with the internationally accepted Tubersol. Additionally, there was poor agreement between the TSTs and QFT plus test.</p></div>","PeriodicalId":37942,"journal":{"name":"Journal of Clinical Tuberculosis and Other Mycobacterial Diseases","volume":null,"pages":null},"PeriodicalIF":1.9000,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2405579423000608/pdfft?md5=f241b1c00e529358b2937fdf7d0764ab&pid=1-s2.0-S2405579423000608-main.pdf","citationCount":"0","resultStr":"{\"title\":\"Tuberculin test using Indian indigenous purified-protein derivative (PPD) shows only moderate agreement with international standard PPD\",\"authors\":\"Devasahayam J. Christopher , N. Priya , Deepa Shankar , Barney Isaac , Andrea DeLuca , Sonali Sarkar , Senbagavalli Prakash Babu , Prasanna Samuel , Adithya Cattamanchi , Amita Gupta , Jerrold Ellner , Sudha Srinivasan , Samyra Cox , Balamugesh Thangakunam\",\"doi\":\"10.1016/j.jctube.2023.100404\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><p>In India, the prevalence of Latent TB infection (LTBI) is estimated to be around 40%. Various formulations of PPD(Purified protein derivative) are available, for diagnosis of LTBI, which may give variable responses. The commercially available PPD in India is by Arkray Healthcare (TST-Arkray). It is unclear if this product may have a similar sensitivity compared to other internationally accepted tuberculins (TST-Tubersol).</p></div><div><h3>Objectives</h3><p>To assess the performance of the two TSTs compared to Quantiferon-Gold Plus (QFT-Plus).</p></div><div><h3>Methodology</h3><p>A blood sample was collected for the QFT-Plus test. Both the TSTs were placed in the right and the left volar aspect of the forearms and 48 hrs later, the subjects came back to the study site for reading.</p></div><div><h3>Results</h3><p>Among the 512 participants who were recruited, 326 subjects were healthcare professionals and 186 subjects were household contacts of patients with tuberculosis. They were tested with both TST-Tubersol and TST-Arkray, 139(27 %) participants tested positive for TST-Tubersol (≥10 mm), whereas 203 participants (40.1 %)tested positive for TST-Arkray. There was moderate agreement between the two tests with k = 0.58. Also, there was only poor agreement between both the TSTs with QFT Plus(kappa = 0.19 for Tubersol and 0.17 for Arkray). With QFT-Plus as gold standard, the sensitivity, specificity, PPV and NPV of TST-Tubersol, ast an induration cut-off of 10 mm was 46.8 %,76.3 %,31.8 % and 85.8 %. respectively and TST- Arkray; 60.6 %, 64 %, 28.5 % and 87.2 % respectively.</p></div><div><h3>Conclusion</h3><p>The Indian TST (Arkray Diagnostics) has shown moderate agreement with the internationally accepted Tubersol. 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Tuberculin test using Indian indigenous purified-protein derivative (PPD) shows only moderate agreement with international standard PPD
Background
In India, the prevalence of Latent TB infection (LTBI) is estimated to be around 40%. Various formulations of PPD(Purified protein derivative) are available, for diagnosis of LTBI, which may give variable responses. The commercially available PPD in India is by Arkray Healthcare (TST-Arkray). It is unclear if this product may have a similar sensitivity compared to other internationally accepted tuberculins (TST-Tubersol).
Objectives
To assess the performance of the two TSTs compared to Quantiferon-Gold Plus (QFT-Plus).
Methodology
A blood sample was collected for the QFT-Plus test. Both the TSTs were placed in the right and the left volar aspect of the forearms and 48 hrs later, the subjects came back to the study site for reading.
Results
Among the 512 participants who were recruited, 326 subjects were healthcare professionals and 186 subjects were household contacts of patients with tuberculosis. They were tested with both TST-Tubersol and TST-Arkray, 139(27 %) participants tested positive for TST-Tubersol (≥10 mm), whereas 203 participants (40.1 %)tested positive for TST-Arkray. There was moderate agreement between the two tests with k = 0.58. Also, there was only poor agreement between both the TSTs with QFT Plus(kappa = 0.19 for Tubersol and 0.17 for Arkray). With QFT-Plus as gold standard, the sensitivity, specificity, PPV and NPV of TST-Tubersol, ast an induration cut-off of 10 mm was 46.8 %,76.3 %,31.8 % and 85.8 %. respectively and TST- Arkray; 60.6 %, 64 %, 28.5 % and 87.2 % respectively.
Conclusion
The Indian TST (Arkray Diagnostics) has shown moderate agreement with the internationally accepted Tubersol. Additionally, there was poor agreement between the TSTs and QFT plus test.
期刊介绍:
Journal of Clinical Tuberculosis and Mycobacterial Diseases aims to provide a forum for clinically relevant articles on all aspects of tuberculosis and other mycobacterial infections, including (but not limited to) epidemiology, clinical investigation, transmission, diagnosis, treatment, drug-resistance and public policy, and encourages the submission of clinical studies, thematic reviews and case reports. Journal of Clinical Tuberculosis and Mycobacterial Diseases is an Open Access publication.