The evaluation of whole blood cytokine assay for diagnosis of M.tuberculosis infection in South African children with household tuberculosis contact.
| dc.contributor.author | Masilo, J. M. | |
| dc.contributor.co-supervisor | Adrian, P. V., Dr. | |
| dc.contributor.supervisor | Grobler, C. J., Dr. | |
| dc.date.accessioned | 2022-01-27T23:39:20Z | |
| dc.date.available | 2022-01-27T23:39:20Z | |
| dc.date.issued | 2019-04 | |
| dc.description | M. Tech. (Department of Biotechnology, Faculty of Applied and Computer Sciences), Vaal University of Technology. | en_US |
| dc.description.abstract | Background: There are critical unmet needs for improved strategies in the detection and diagnosis of M.tuberculosis infection in children, and for prevention of tuberculosis disease in children. Bacillus Calmette-Guérin (BCG) vaccination has limited the utility of tuberculin skin testing (TST) in areas with high vaccine coverage. Objectives: The aim of this study was to estimate the prevalence of M.tuberculosis infection in children with household tuberculosis contacts, using QFT-GIT testing in comparison with TST. Methods: This study was a cross-sectional design to assess the performance of a new T-cell based blood test, namely QuantiFERON-TB Gold In Tube (QFT-GIT), for diagnosis of tuberculosis infection in the children (n=182) of adults (n=124) with pulmonary tuberculosis, additionally to determine the prevalence of M.tuberculosis infection in children with household tuberculosis contacts, using QFT-GIT testing in comparison with TST. The study was carried out at Chris Hani Hospital. For children involved in the study, tuberculosis exposure information was obtained, together with TST, QFT-GIT, and HIV testing. Data obtained from both experiments was statistically analysed using SPSS version 24 to determine whether there was a significant agreement between QFT-GIT and TST on the detection of M.tuberculosis prevalence in children with house hold contacts with confirmed M.tuberculosis infection. Results: This study examined the sensitivity and specificity of the QFT-GIT tests compared with the standard TST for diagnosing latent tuberculosis disease in paediatric contacts. Because of the lack of a latent tuberculosis “gold standard”, the specificity and sensitivity of QFT-GIT was calculated with a two-by-two table method. The specificity of the QFT-GIT was 84% and the sensitivity was 85%. There was a good correlation between QFT-GIT and TST (Cohen’s kappa of 0.705). Seventeen percent (17%) of the 182 children tested by QFT-GIT yielded indeterminate results. Age was associated with indeterminate QFT-GIT results in paediatric tuberculosis contacts. Point prevalence for QFT-GIT was recorded as 31% at baseline and 39.5% after six months indicating variability between QFT-GIT results at baseline and after six months. Conclusion: It was concluded that the prevalence of tuberculosis infection was common among South African children who live with an adult with active tuberculosis. The agreement between QFT-GIT assay and TST for the diagnosis of latent tuberculosis in children was high. Although TST and QFT-GIT assays appeared comparable, QFT-GIT showed higher positivity rate amongst those contacts with reported household tuberculosis exposure compared to TST. The QFTGIT assay was a better indicator of the risk of M.tuberculosis infection than TST in a BCG-vaccinated population. | en_US |
| dc.identifier.uri | http://hdl.handle.net/10352/477 | |
| dc.language.iso | en | en_US |
| dc.publisher | Vaal University of Technology | en_US |
| dc.subject | M.tuberculosis infection in children | en_US |
| dc.subject | Blood cytokine assay | en_US |
| dc.subject | Prevention of tuberculosis disease in children | en_US |
| dc.subject | Bacillus Calmette-Guérin (BCG) | en_US |
| dc.subject | QFT-GIT assay | en_US |
| dc.subject | TST | en_US |
| dc.subject.lcsh | Dissertations, Academic -- South Africa | en_US |
| dc.subject.lcsh | Tuberculosis | en_US |
| dc.subject.lcsh | Respiratory infections | en_US |
| dc.subject.lcsh | Tuberculosis in children | en_US |
| dc.subject.lcsh | Tuberculosis -- South Africa | en_US |
| dc.subject.lcsh | Tuberculosis -- Treatment | en_US |
| dc.title | The evaluation of whole blood cytokine assay for diagnosis of M.tuberculosis infection in South African children with household tuberculosis contact. | en_US |
| dc.type | Thesis | en_US |