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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