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Tuberculin skin testing versus interferon-gamma release assay among users of a public health unit in Northeast Portugal

2021Journal article Open access
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dc.contributor.authorAfonso, Andrea Luísa Fernandes
dc.contributor.authorPires, Bruno
dc.contributor.authorTeixeira, Cristina
dc.contributor.authorNogueira, António José M.
dc.date.accessioned2021-03-04T16:05:56Z
dc.date.available2021-03-04T16:05:56Z
dc.date.issued2021
dc.description.abstracthe screening of groups with a high risk for developing tuberculosis (TB) is a priority in order to control this disease. Since there is no gold standard for the diagnosis of latent TB infection (LTBI), both the tuberculin skin test (TST) and the interferon-gamma release assays (IGRA) have been used for this purpose. The aim of this study was to determine the proportion of LTBI by using the TST and the IGRA tests, and to assess the risk factors related with discordant results between tests across several risk groups advised for screening in Northeast Portugal. Data were collected from the database of patients with suspected LTBI and advised for the screening in a public health unit (January 2014 to December 2015). The proportion of LTBI was computed using both tests. Logistic regression models assessed risk factors for a positive test and for discordant results between tests. The adjusted odds ratio (OR) and respective 95% confidence interval (95% CI) were obtained. Out of 367 patients included in the analysis, 79.8% had a positive TST and 46.0% of them had a positive IGRA. In comparison with contacts of active TB cases, healthcare workers and inmates presented higher odds of TST positivity (OR 4.38, 95% CI 1.59–12.09 and OR 4.74, 95% CI 1.45–15.49, respectively), but immunocompromised people presented lower odds of TST positivity (OR 0.14; 95% CI 0.06–0.31). Instead, healthcare workers (OR 0.44, 95% CI 0.24–0.80) and immunocompromised people (OR 0.24, 95% CI 0.10–0.56) presented lower odds of a positive IGRA. There were 42.0% concordant positive results, 16.1% concordant negative results, and 41.9% discordant results, with healthcare workers presenting higher odds of discordant results (OR 3.34, 95% CI 1.84–6.05). The proportion of LTBI estimated by TST and IGRA among people advised for screening in our setting is high, highlighting the need of preventive strategies. Among healthcare workers, TST results should be read with caution as the higher proportion of discordant results with a positive TST suggests the impact of the booster reaction in this group.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationAfonso, Andrea; Pires, Bruno Miguel Morais; Teixeira, Cristina; Nogueira, António José M. (2021.Tuberculin skin testing versus interferon-gamma release assay among users of a public health unit in Northeast Portugal. Portuguese Journal of Public Health. ISSN 2504-3137. p. 159-165pt_PT
dc.identifier.issn2504-3137
dc.identifier.urihttp://hdl.handle.net/10198/23466
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherEscola Nacional de Saúde Públicapt_PT
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/pt_PT
dc.subjectTuberculosispt_PT
dc.subjectLatent tuberculosis infectionpt_PT
dc.subjectTuberculin skin testpt_PT
dc.subjectInterferon-gamma release assaypt_PT
dc.titleTuberculin skin testing versus interferon-gamma release assay among users of a public health unit in Northeast Portugalpt_PT
dc.typejournal article
dcterms.titleTeste intradérmico da tuberculina versus teste de deteção de interferão-gama numa unidade de saúde no nordeste de Portugal
dspace.entity.typePublication
oaire.citation.conferencePlaceLisboapt_PT
oaire.citation.endPage165pt_PT
oaire.citation.startPage159pt_PT
oaire.citation.titlePortuguese Journal of Public Healthpt_PT
oaire.citation.volume38pt_PT
person.familyNameAfonso
person.familyNameTeixeira
person.familyNameNogueira
person.givenNameAndrea Luísa Fernandes
person.givenNameCristina
person.givenNameAntónio José M.
person.identifier.ciencia-id9C1D-41E7-9BBF
person.identifier.ciencia-id6E12-F2A0-568F
person.identifier.ciencia-id8A11-794E-36BD
person.identifier.orcid0000-0002-8858-1617
person.identifier.orcid0000-0001-5194-5141
person.identifier.orcid0000-0001-8912-7355
person.identifier.ridO-2296-2013
person.identifier.scopus-author-id36766901000
person.identifier.scopus-author-id55207402700
person.identifier.scopus-author-id55865568268
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT
relation.isAuthorOfPublicationaf7d647c-f5a6-48f7-afcf-6307c3677b1d
relation.isAuthorOfPublication9037c83c-43c1-4714-ad3e-9f307dd1d89f
relation.isAuthorOfPublication648209a2-eec9-4bec-975a-32673e41b95c
relation.isAuthorOfPublication.latestForDiscovery648209a2-eec9-4bec-975a-32673e41b95c

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