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Efficiency of Immunological Methods in the Diagnosis of Active Tuberculosis in Children



Author(s)

Anna Starshinova, Irina Dovgaliuk, Natalia Korneva, Ulia Ovchinnikova, Olga Yakunova, Elena Potapenco, Maria Shulgina, Elmira Zilber and Piotr Yablonskii

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DOI:10.17265/1548-6648/2014.02.003

Nowadays, no clear diagnostic criteria for tuberculosis in children exist as absolute majority of tuberculosis cases in childhood have no bacterial excretion, unlike adults where bacterial excretion is observed not rarely. This fact leads to necessity to implement immunological methods in diagnostic complex in children. Tuberculin test is a routine one which is used for diagnosis of tuberculosis. However, there are a number of factors which interfere with the diagnostic value of tuberculin test. This study helped to ascertain the superiority of DST (Diaskintest) and QFT-G (QuantiFERON®-TB Gold IT) with respect to the wealth of information they provide when compared with the TST (tuberculin screening test) in determining the activity of tuberculosis infection in children. The evaluation parameters of diagnostic value (DSS (diagnostic sensitivity), the DSC (diagnostic specificity), PPV (positive predictive value) and NPV (negative predictive value), and DE (diagnostic efficiency)) with DST, QFT and TST (tuberculin skin test) were: DSS—84.3%, DSC—59.1%, PPV—61.9%, NPV—82.7%, DE—71.7%) with QFT (DSS—78.4%, DSC—68.2%, PPV—57.7%, NPV—85.1%, DE—73.3%) were significantly higher than with TST (DSS—91.5%, DSC—15.7%, PPV—74.4%, NPV—45.8%, DE—53.6%). New immunologic methods DST and QFT-G have higher specificity and diagnostic value in comparison with TST that makes their implementation in the diagnosis of TB in children essential.

Tuberculosis, children, Diaskintest, QuantiFERON-TB test, immunology.