Testing of tuberculosis infection among Chinese adolescents born after terminating the Bacillus Calmette--Guérin booster vaccination: subgroup analysis of a population-based cross-sectional study

Abstract

The prevalence of tuberculosis infection among adolescents born after terminating the Bacillus Calmette–Guérin (BCG) booster vaccination in China was estimated using tuberculin skin testing (TST) and QuantiFERON-TB Gold assay (QFT) to investigate the influence of neonatal BCG vaccination on the performance of TST. Data analysis was conducted for 2831 eligible participants aged 5–15 years from the baseline survey of a population-based multi-center prospective study. The prevalence rates of TST (induration≥10 mm) and QFT positivity were 9.3% (264/2827) and 2.5% (71/2831), respectively. The rate of QFT indeterminate result was 2.2% (62/2831). The overall agreement between TST and QFT was low (concordance= 88.0%; κ coefficient= 0.125). Only TST was positively associated with BCG vaccination with an adjusted odds ratio of 1.71 [95% confidence interval, 1.26–2.31]. A history of close contact with patients of active TB was significantly associated with positivity for TST and QFT. Our results suggested that BCG neonatal vaccination still affects TST performance, and a two-step approach might be considered for TB infection testing among adolescents in China.

Keywords

tuberculin skin test / interferon-γ release assays / adolescent / agreement

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Acknowledgements

We thank all the investigators from the study sites of the LATENTTB-NSTM study for their contributions to the survey. This study was funded by the National Science and Technology Major Project of China (Nos. 2013ZX10003004-002 and 2014ZX10003001-001), the Program for Changjiang Scholars and Innovative Research Team in University of China (No. IRT13007), the CAMS Innovation Fund for Medical Sciences (No. 2016-I2M-1-013), and the Sanming Project of Medicine in Shenzhen (No. GCZX2015043015340574).

Compliance with ethics guidelines

Hengjing Li, Henan Xin, Shukun Qian, Xiangwei Li, Haoran Zhang, Mufei Li, Boxuan Feng, Qi Jin, and Lei Gao declare that they have no conflict of interest. All procedures followed were in accordance with the ethical standards of the ethics committee of the Institute of Pathogen Biology, Chinese Academy of Medical Sciences (Beijing, China) and with the Helsinki Declaration of 1975, as revised in 2000. Informed consent was obtained from parents or guardians for each participant being included in the study.

Electronic Supplementary Material

Supplementary material is available in the online version of this article at http://dx.doi.org/ 10.1007/s11684-017-0573-0 and is accessible for authorized users.

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