Comparative performance of QuantiFERON-TB Gold versus skin test with tuberculosis recombinant allergen (Diaskintest) among patients with suspected pulmonary tuberculosis in Russia

Int J Infect Dis. 2019 Sep:86:18-24. doi: 10.1016/j.ijid.2019.06.014. Epub 2019 Jun 30.

Abstract

Background: The early identification of Mycobacterium tuberculosis infection can prevent tuberculosis (TB) transmission. A skin test with a tuberculosis recombinant allergen (Diaskintest) is a new method for identification that has been implemented in Russia. This study was performed to compare the performances of Diaskintest and QuantiFERON-TB Gold (QFT) in adults and children with suspected TB in Moscow, Russia.

Methods: Adults (n=85) and children (n=96) were tested using Diaskintest and QFT. Concordance and comparative analyses were performed.

Results: Diaskintest and QFT were concordant in 84% of adults and 90% of children (overall concordance 87%, κ>0.6, Kc>0.5). The concordance between QFT, Diaskintest, and the final diagnosis was good in adults (86% and 81%, respectively) and moderate in children (77% and 79%, respectively). In adults, QFT had a higher sensitivity for detecting TB than Diaskintest (82% and 68%, respectively); in children, Diaskintest was more sensitive (73% and 65%, respectively). In patients with a confirmed TB diagnosis, negative Diaskintest/QFT results were associated with low disease activity. Combined Diaskintest/QFT results identified TB patients with higher sensitivity and specificity than each test separately.

Conclusions: Diaskintest is a low-cost diagnostic tool that shows a test positivity rate similar to QFT and can be used in combination with QFT as an adjunctive test for TB diagnosis.

Keywords: Diaskintest; QuantiFERON-TB Gold; Skin test with tuberculosis recombinant allergen; Tuberculosis.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Antigens, Bacterial / analysis*
  • Child
  • Child, Preschool
  • Diagnostic Tests, Routine / methods*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Russia
  • Sensitivity and Specificity
  • Tuberculin Test / methods*
  • Tuberculosis, Pulmonary / diagnosis*
  • Tuberculosis, Pulmonary / microbiology
  • Young Adult

Substances

  • Antigens, Bacterial