诊断性能比较评估：标准 E TB Feron ELISA 与 QuantiFERON-TB Gold Plus 在孟加拉国不同风险群体中的潜伏肺结核感染检测效果比较

IF 2.9 3区医学 Q2 INFECTIOUS DISEASES

Infection and Drug Resistance Pub Date : 2024-09-09 DOI:10.2147/idr.s475424

Mohammad Khaja Mafij Uddin, Ashabul Islam, Maha Sultana Jabin, Tahmina Alam, Salwa Khair, Jannatul Ferdous, Rumana Nasrin, S M Mazidur Rahman, Stephane Pouzol, Jonathan Hoffmann, Sayera Banu

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引用次数: 0

摘要

背景：全球约有四分之一的人口患有肺结核潜伏感染（LTBI）。如果不及时治疗，LTBI 终生有 5%-10%的风险发展为肺结核。γ干扰素释放测定（IGRA）比结核菌素皮试更灵敏。然而，IGRA 的高成本和复杂性阻碍了它在资源有限的环境中的应用。本研究评估了一种更经济实惠的 IGRA--标准 E TB-Feron（TBE）--在孟加拉国不同风险人群中的诊断性能。方法：2023 年 6 月至 9 月期间，icddr.b 在结核病筛查和治疗中心及达卡医院招募了 532 名各年龄段的参与者。参与者被分为四类风险人群：健康人群、结核病患者的医护人员/护理人员、经微生物学确诊的结核病患者以及有结核病史的人群。在所有组别中，TBE 的诊断性能都与 QuantiFERON-TB Gold Plus (QFT-Plus) 进行了比较。基因Xpert、培养和显微镜检查用于结核病的微生物学确诊：TBE 与 QFT-Plus 的总体一致性为 85.9%（95% CI，82.5% 至 88.7%），阳性一致性为 86.1%（95% CI，80.6% 至 90.5%），阴性一致性为 85.7%（95% CI，81.3% - 89.4%）。在 81 名培养阳性患者中，TBE 和 QFT-Plus 的阳性率分别为 60 例（74.1%）和 62 例（76.5%）。在健康人群中，TBE 和 QFT 阳性的分别有 49 人（24.5%）和 59 人（29.5%）。在医务人员和接触者中，TBE和QFT-Plus呈阳性的分别有79人（39.5%）和73人（35.5%）：我们发现 TBE 和 QFT-Plus 在不同人群中检测 LTBI 的结果非常一致（Cohen's kappa 为 0.71），这表明 TBE 有潜力成为一种经济有效的诊断工具。在常规临床实践中使用 TBE 可以提高 LTBI 诊断的可及性，促进预防性治疗的及时启动，从而降低活动性肺结核的发病率。

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Comparative Evaluation of Diagnostic Performance: Standard E TB Feron ELISA vs QuantiFERON-TB Gold Plus for Latent Tuberculosis Infection Detection in Diverse Risk Groups in Bangladesh

Background: Around one-quarter of the global population has latent tuberculosis infection (LTBI). If left untreated, LTBI has 5– 10% lifetime risk of developing into TB. Interferon-gamma release Assays (IGRAs) are more sensitive than the tuberculin skin test for LTBI detection. However, the high cost and complexity of IGRAs are barriers to adoption in resource-constrained settings. This study evaluated the diagnostic performance of a more affordable IGRA, Standard E TB-Feron (TBE), among different risk groups in Bangladesh.
Methods: 532 participants of all age groups were enrolled from the TB Screening and Treatment Centers and Dhaka Hospital of icddr,b between June and September 2023. The participants were categorized into four risk groups: healthy people, healthcare workers/ attendants of TB patients, patients with microbiologically confirmed TB, and people with a history of TB. The diagnostic performance of TBE was compared to QuantiFERON-TB Gold Plus (QFT-Plus) for all groups. GeneXpert, culture, and microscopy were used to confirm TB microbiologically.
Results: TBE had an overall agreement of 85.9% (95% CI, 82.5% to 88.7%), positive percent agreement of 86.1% (95% CI, 80.6% to 90.5%), and negative percent agreement of 85.7% (95% CI, 81.3% − 89.4%) with QFT-Plus. Among 81 culture-positive patients, TBE and QFT-Plus were positive for 60 (74.1%) and 62 (76.5%) respectively. Among healthy people, TBE and QFT results were positive for 49 (24.5%) and 59 (29.5%) respectively. Among health workers and contacts, TBE and QFT-Plus were positive for 79 (39.5%) and 73 (35.5%) respectively.
Conclusion: We found a substantial agreement (Cohen’s kappa of 0.71) between TBE and QFT-Plus in detecting LTBI across different groups, suggesting its potential as a cost-effective diagnostic tool. Implementation of TBE in routine clinical practice could increase accessibility to LTBI diagnosis, facilitating the timely initiation of preventative therapy, and leading to a reduction of active TB incidence.

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来源期刊

Infection and Drug Resistance Medicine-Pharmacology (medical)

CiteScore

5.60

自引率

7.70%

发文量

826

审稿时长

16 weeks

期刊介绍： About Journal Editors Peer Reviewers Articles Article Publishing Charges Aims and Scope Call For Papers ISSN: 1178-6973 Editor-in-Chief: Professor Suresh Antony An international, peer-reviewed, open access journal that focuses on the optimal treatment of infection (bacterial, fungal and viral) and the development and institution of preventative strategies to minimize the development and spread of resistance.