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Diagnosis of latent tuberculosis infection in healthy young adults in a country with high tuberculosis burden and BCG vaccination at birth
Authors:Alemnew F Dagnew  Jemal Hussein  Markos Abebe  Martha Zewdie  Adane Mihret  Ahmed Bedru  Menberework Chanyalew  Lawrence Yamuah  Girmay Medhin  Peter Bang  T Mark Doherty  Asrat Hailu  Abraham Aseffa
Abstract:ABSTRACT: BACKGROUND: One third of the world's population is thought to have latent tuberculosis infection (LTBI) with the potential for subsequent reactivation of disease. To better characterize this important population, studies comparing Tuberculin Skin Test (TST) and the new interferon-gamma release assays including QuantiFERON(R)-TB Gold In-Tube (QFT-GIT) have been conducted in different parts of the world, but most of these have been in countries with a low incidence of tuberculosis (TB). OBJECTIVE: To evaluate the use of QFT-GIT assay as compared with TST in the diagnosis of LTBI in a country with a high burden of TB and routine BCG vaccination at birth. METHODS: Healthy medical and paramedical male students at the Faculty of Medicine, Addis Ababa University, Ethiopia were enrolled into the study from December 2008 to February 2009. The TST and QFTG-IT assay were performed using standard methods. RESULTS: The mean age of the study participants was 20.9 years. From a total of 107 study participants, 46.7% (95%CI: 37.0% to 56.6%) had a positive TST result (TST greater than or equal to 10 mm), 43.9% (95%CI: 34.3% to 53.9%) had a positive QFT-GIT assay result and 44.9% (95%CI: 35.2% to 54.8%) had BCG scar. There was strong agreement between TST (TST greater than or equal to 10mm) and QFT-GIT assay (Kappa = 0.83, p value=0.000). CONCLUSION: The TST and QFT-GIT assay show similar efficacy for the diagnosis of LTBI in healthy young adults residing in Ethiopia, a country with high TB incidence.
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