Implementation of an interferon-gamma release assay to screen for tuberculosis in refugees and immigrants.

Abstract

Despite increased use and accuracy of interferon-gamma release assays to detect latent tuberculosis infection (LTBI) in foreign-born arrivals in the United States, risk characteristics associated with positive results are not well characterized. We conducted a retrospective record review of 541 refugees and immigrants screened for LTBI with QuantiFERON(®)-TB Gold In-Tube (QFT-IT) at the Spokane Public Health Clinic from January 2, 2008, through June 5, 2009. Overall, 24 % of the arrivals had a positive QFT-IT, with the greatest frequency of positive results occurring in arrivals from Liberia (100 %) and Bhutan (39 %). More than the expected number of Burmese had indeterminate QFT-IT results. A positive QFT-IT was associated with age, race, ethnicity, and extent of TB burden in the country of origin. QFT-IT is useful to screen for LTBI in foreign-born arrivals, particularly middle-aged adults from high-burden countries. However, the QFT-IT may not yield meaningful results in groups with significant immunocompromise.

• Authors: Terri Simpson, Julie Tomaro, Cynthia Jobb
• Journal: Journal of immigrant and minority health (J Immigr Minor Health) Vol. 15 Issue 4 Pg. 686-92 (Aug 2013) ISSN: 1557-1920 [Electronic] United States
• PMID: 23179470 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Topics

• Adolescent
• Adult
• Age Factors
• Aged
• Aged, 80 and over
• Ambulatory Care Facilities
• Bhutan
• Child
• Child, Preschool
• Emigrants and Immigrants (statistics & numerical data)
• Ethnicity
• Female
• Humans
• Interferon-gamma Release Tests
• Latent Tuberculosis (diagnosis, ethnology)
• Liberia
• Male
• Mass Screening (methods)
• Middle Aged
• Myanmar
• Refugees (statistics & numerical data)
• Retrospective Studies
• Risk Factors
• Washington (epidemiology)