Summary of the test performance of interferon-gamma release assays and the tuberculin skin test (at ≥10 mm and ≥5 mm cut-offs) in children with tuberculosis according to demographics, confirmation status and clinical characteristics
| No of patients with positive test result/no of patients tested Test sensitivity (95% CI) | QFT-Plus versus QFT-GIT * | TST10 vs | TST5 vs | |||||||||
| QFT-Plus n=358 | QFT-GIT n=600 | T-SPOT.TB n=58 | TST10 n=636 | TST5 n=636 | QFT- Plus* | QFT- GIT* | T-SPOT. TB* | QFT- Plus * | QFT- GIT * | T-SPOT. TB* | ||
| Entire cohort | 300/358 83.8 (80.2 to 87.8) | 513/600 85.5 (82.7 to 88.3) | 45/58 77.6 (66.9 to 88.3) | 530/636 83.3 (80.4 to 86.2) | 572/636 89.9 (87.6 to 92.3) | 0.47 | 0.84 | 0.29 | 0.26 | 0.004 | 0.017 | 0.004 |
| Male | 153/188 81.4 (76.3 to 87.3) | 276/325 84.9 (81.0 to 88.8) | 26/31 83.9 (70.9 to 96.8) | 284/339 83.8 (79.9 to 87.7) | 305/339 90.0 (86.8 to 93.2) | 0.29 | 0.48 | 0.68 | 0.98 | 0.005 | 0.05 | 0.29 |
| Female | 147/170 86.5 (81.3 to 91.6) | 236/274 86.1 (82.0 to 90.2) | 19/27 70.4 (53.1 to 87.6) | 245/296 82.8 (78.5 to 87.1) | 266/296 89.9 (86.4 to 93.3) | 0.92 | 0.29 | 0.27 | 0.11 | 0.26 | 0.17 | 0.003 |
| Age <1 year | 33/39 84.6 (73.3 to 95.9) | 51/59 86.4 (77.7 to 95.2) | 3/4 75.0 (32.6 to 100.0) | 28/45 62.2 (48.1 to 76.4) | 37/45 82.2 (71.1 to 93.4) | 0.80 | 0.02 | 0.004 | 0.61 | 0.77 | 0.55 | 0.72 |
| Age 1–5 years | 114/141 80.9 (74.4 to 87.3) | 230/272 84.6 (80.3 to 88.9) | 15/17 88.2 (72.9 to 100.0) | 235/285 82.5 (78.0 to 86.9) | 255/285 89.5 (85.9 to 93.0) | 0.34 | 0.68 | 0.5 | 0.54 | 0.014 | 0.08 | 0.87 |
| Age 6–10 years | 48/57 84.2 (74.7 to 93.7) | 83/100 83.0 (75.6 to 90.4) | 12/14 85.7 (67.4 to 100.0) | 111/131 84.7 (78.6 to 90.9) | 116/131 89.5 (83.1 to 94.0) | 0.84 | 0.93 | 0.72 | 0.92 | 0.41 | 0.22 | 0.75 |
| Age >10 years | 105/121 86.8 (81.6 to 93.4) | 149/169 88.2 (83.3 to 93.0) | 15/23 65.2 (45.8 to 84.7) | 156/175 89.1 (84.5 to 93.8) | 164/175 93.7 (90.1 to 97.3) | 0.72 | 0.53 | 0.77 | 0.0017 | 0.04 | 0.07 | <0.0005 |
| Confirmed TB | 159/182 87.4 (81.6 to 91.8) | 243/285 85.3 (80.6 to 89.2) | 24/33 72.7 (54.5 to 86.7) | 213/268 79.5 (74.1 to 84.1) | 237/268 88.4 (84.0 to 92.0) | 0.52 | 0.03 | 0.07 | 0.37 | 0.73 | 0.27 | 0.012 |
| Unconfirmed TB | 141/176 80.1 (73.4 to 85.7) | 270/315 85.7 (81.3 to 89.4) | 21/25 84.0 (64.0 to 95.5) | 317/368 86.1 (82.2 to 89.5) | 335/368 91.0 (87.6 to 93.7) | 0.11 | 0.07 | 0.87 | 0.76 | 0.0003 | 0.03 | 0.24 |
| Respiratory TB | 230/268 85.8 (81.6 to 90.0) | 386/445 86.7 (83.6 to 89.9) | 35/41 85.4 (74.5 to 96.2) | 413/487 84.8 (81.6 to 88.0) | 441/487 90.6 (88.0 to 93.2) | 0.73 | 0.70 | 0.40 | 0.92 | 0.05 | 0.06 | 0.28 |
| Miliary and/or CNS TB | 19/26 73.1 (56.0 to 90.1) | 39/55 70.9 (58.9 to 82.9) | 7/11 63.6 (35.2 to 92.1) | 20/46 43.5 (29.2 to 57.8) | 31/46 67.4 (53.8 to 80.9) | 0.84 | 0.015 | 0.005 | 0.23 | 0.61 | 0.70 | 0.81 |
| Other focus† | 51/64 79.7 (71.3 to 90.6) | 87/99 87.9 (81.4 to 94.3) | 3/6 50.0 (10.0 to 90.0) | 97/103 94.2 (89.7 to 98.7) | 100/103 97.1 (93.8 to 100.0) | 0.15 | 0.004 | 0.12 | 0.0001 | 0.0002 | 0.012 | <0.0005 |
| Pre-existing comorbidities | 39/49 79.6 (68.3 to 90.9) | 56/81 69.1 (59.1 to 79.2) | 5/13 38.5 (12.0 to 64.9) | 55/80 68.8 (58.6 to 78.9) | 61/80 76.3 (66.9 to 85.6) | 0.19 | 0.18 | 0.96 | 0.03 | 0.66 | 0.31 | 0.005 |
| Immunocompromise (including HIV) | 18/24 75.0 (57.7 to 92.3) | 28/47 59.6 (45.5 to 73.6) | 5/11 45.5 (16.0 to 74.9) | 26/44 59.1 (44.6 to 73.6) | 30/44 68.2 (54.4 to 81.9) | 0.19 | 0.19 | 0.96 | 0.41 | 0.55 | 0.39 | 0.16 |
*P values based on two-sided Wald χ2 tests with Bonferroni correction (α=0.017) to account for multiple comparisons.
†Other disease focus comprised: lymph node, osteoarticular, genitourinary, abdominal and pericardial TB.
CNS, central nervous system; QFT-GIT, QuantiFERON-TB Gold in-Tube; QFT-Plus, QuantiFERON-TB Gold-Plus; TB, tuberculosis; TST, tuberculin skin test.