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Comparison of Quantiferon-Tb Gold In-Tube (Qft-Git) and Tuberculin Skin Test (Tst) for Diagnosis of Latent Tuberculosis in Haemodialysis (Hd) Patients: A Meta-Analysis of Κ Estimates Publisher Pubmed



Ayubi E1, 2, 3 ; Doostiirani A4 ; Sanjari Moghaddam A5 ; Khazaei S2, 4 ; Mansori K6, 7 ; Safiri S8 ; Sani M9 ; Mostafavi E3, 10
Authors
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Authors Affiliations
  1. 1. Department of Epidemiology, School of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  2. 2. Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
  3. 3. Department of Epidemiology and Biostatistics, Pasteur Institute of Iran, Tehran, Iran
  4. 4. Department of Epidemiology, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
  5. 5. School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  6. 6. Social Determinants of Health Research Center, Kurdistan University of Medical Sciences, Sanandaj, Iran
  7. 7. Department of Epidemiology, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
  8. 8. Department of Public Health, Managerial Epidemiology Research Center, School of Nursing and Midwifery, Maragheh University of Medical Sciences, Maragheh, Iran
  9. 9. School of Medicine, Zabol University of Medical Sciences, Zabol, Iran
  10. 10. Research Centre for Emerging and Reemerging Infectious Diseases, Pasteur Institute of Iran, Tehran, Iran

Source: Epidemiology and Infection Published:2017


Abstract

Diagnosis of latent tuberculosis infection (LTBI) is a concern in haemodialysis (HD) patients. Many studies have compared QuantiFERON-TB Gold In-Tube (QFT-GIT) and tuberculin skin test (TST) for detecting LTBI and reported the κ statistic of agreement between QFT-GIT and TST in HD patients. The present study aimed to systematically review this literature and conduct meta-analysis of individual studies that estimated the κ between QFT-GIT with TST among HD patients. All relevant published studies that were available as full-text were obtained by searching Medline (1950), Web of Sciences (1945), Scopus (1973) through May 2016. The κ was re-estimated from the individual studies and pooled using random effect meta-analysis. Subgroup analysis and meta-regression were applied to evaluate the effect of Bacillus Calmette-Guerin (BCG) vaccination, TST cut-off points, quality of studies, sample size and age on variation of κ estimate. Eight studies involving 901 HD patients were included in meta-analysis. The pooled κ estimate was 0·28 (I 2 = 18·4%, P = 0·239, 95% confidence intervals 0·22-0·34). The discordance of TST-/QFT-GIT+ was more than TST+/QFT-GIT-. History of BCG vaccination, TST cut-off points and age are related to variation of κ estimates. TST and QFT-GIT are not comparable in detecting LTBI in HD patients. The higher TST-/QFT-GIT+ ratio compared with TST+/QFT-GIT- ratio, may indicate the superiority of QFT-GIT over TST for detection LTBI in HD patients. © Copyright 2017 Cambridge University Press.
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