This prospective cohort study was conducted to compare the accuracy of QuantiFERON®-TB (QFT) Gold In-Tube test and tuberculin skin test (TST) in diagnosing tuberculosis (TB) in predominantly bacille Calmette-Guerin-vaccinated children with a high incidence of malnutrition. The sensitivity of the QFT versus the TST was 69.6% versus 52.9% for WHO-defined TB, with specificity of 86% versus 78.3%, respectively. The concordance of the TST and QFT was 79% overall (κ = 0.430), 62.5% in those with WHO-defined TB and 85.7% in those without TB. Majority of the QFT+/TST - discordance was seen in children with TB, whereas majority of the TST+/QFT - discordance was seen in those without TB. The TST was more likely to be negative in children with moderate-to-severe malnutrition (P = 0.003) compared to the QFT, which was more likely to be positive in younger children. The significantly better performance of the QFT in malnourished children and those at younger ages supports its use for TB diagnosis in these subpopulations.

中文翻译：

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QuantiFERON®-TB 黄金管内试验与结核菌素皮试在诊断印度营养不良儿童结核病中的效用。

这项前瞻性队列研究旨在比较 QuantiFERON®-TB (QFT) 金管试验和结核菌素皮试 (TST) 在主要接种卡介苗疫苗的儿童中诊断结核病 (TB) 的准确性，这些儿童的结核病发病率很高。营养不良。对于 WHO 定义的结核病，QFT 与 TST 的敏感性分别为 69.6% 和 52.9%，特异性分别为 86% 和 78.3%。TST 和 QFT 的总体一致性为 79% (κ = 0.430)，在 WHO 定义的结核病患者中为 62.5%，在非结核病患者中为 85.7%。大多数 QFT+/TST- 不一致出现在患有结核病的儿童中，而大多数 TST+/QFT- 不一致出现在没有结核病的儿童中。与 QFT 相比，中度至重度营养不良儿童的 TST 更有可能呈阴性（P = 0.003），而 QFT 在年幼的儿童中更有可能呈阳性。QFT 在营养不良儿童和年龄较小的儿童中表现明显更好，支持其在这些亚人群中用于结核病诊断。