1. No added value of interferon-γ release to a prediction model for childhood tuberculosis.
- Author
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Togun TO, Egere U, Gomez MP, Sillah AK, Daramy M, Tientcheu LD, S Sutherland J, Hill PC, and Kampmann B
- Subjects
- Adolescent, Age Factors, Algorithms, Area Under Curve, Child, Child, Preschool, Contact Tracing, Cough diagnosis, Cough etiology, Female, Fever diagnosis, Fever etiology, Humans, Infant, Logistic Models, Lymphadenopathy etiology, Male, Prospective Studies, ROC Curve, Risk Assessment, Tuberculosis complications, Tuberculosis diagnosis, Tuberculosis, Pulmonary complications, Weight Loss, Decision Support Techniques, Interferon-gamma Release Tests, Lymphadenopathy diagnosis, Tuberculosis, Pulmonary diagnosis
- Abstract
The predictive value of a combination of clinical and radiological features with interferon-γ release assay (IGRA) for diagnosis of active tuberculosis (TB) disease among TB-exposed children is unknown.150 symptomatic HIV-negative children (aged 3 months to 14 years), prospectively recruited through active contact tracing, were included. Backward stepwise logistic regression and bootstrapping techniques were used for the development and internal validation of a clinical prediction model for active TB disease. Model discrimination and incremental value of a positive IGRA test were assessed by area under the receiver operating characteristic curve (AUC).35 (23%) children were diagnosed with active TB disease and started on treatment and 115 (77%) had other respiratory tract infections. A final parsimonious clinical model, comprising age <5 years (adjusted (a)OR 4.8, 95% CI 2.0-11.5) and lymphadenopathy on clinical examination (aOR 4.9, 95% CI 1.8-13.0) discriminated active TB disease from other disease with an AUC of 0.70 (95% CI 0.61-0.80). A positive IGRA result did not improve the discriminatory ability of the clinical model (c-statistic 0.72 versus 0.70; p=0.644).A clinical algorithm, including age <5 years and lymphadenopathy classified 70% of active TB disease among symptomatic TB-exposed children. IGRA does not add any discriminatory value to this prediction model., (Copyright ©ERS 2016.)
- Published
- 2016
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