Tuberculin skin test and Quantiferon test agreement and influencing factors in tuberculosis screening of healthcare workers: a systematic review and meta-analysis

被引:21
作者
Lamberti, Monica [1 ]
Uccello, Rossella [1 ]
Lourdes Monaco, Maria Grazia [1 ]
Muoio, Mariarosaria [1 ]
Feola, Daniela [1 ]
Sannolo, Nicola [1 ]
Nienhaus, Albert [2 ,3 ]
Chiodini, Paolo [4 ]
机构
[1] Univ Naples 2, Sect Hyg Occupat Med & Forens, Dept Expt Med, Med, Naples, Italy
[2] Univ Med Ctr Hamburg Eppendorf, Inst Hlth Serv Res Dermatol & Nursing, Ctr Excellence Epidemiol & Hlth Serv Res Healthca, Hamburg, Germany
[3] Inst Statutory Accid Insurance & Prevent Hlth & W, Principles Prevent & Rehabil Dept GPR, Hamburg, Germany
[4] Univ Naples 2, Med Stat Unit, Naples, Italy
关键词
Tuberculosis; Tuberculin skin test; Quantiferon TB Gold; Healthcare workers; Health surveillance; Meta-analysis; Cohen's k; GAMMA-RELEASE ASSAYS; LATENT TUBERCULOSIS; MYCOBACTERIUM-TUBERCULOSIS; TB GOLD; RISK-FACTORS; INFECTION; DIAGNOSIS; PREVALENCE; PERSONNEL; DISEASE;
D O I
10.1186/s12995-015-0044-y
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
Objective: A systematic review and meta-analysis was conducted to evaluate the agreement between Tuberculin Skin Test (TST) and Quantiferon (QFT) in screening for tuberculosis (TB) infection among healthcare workers (HCWs) and to estimate associations between TST and QFT agreement and variables of interest, such as Bacillus Calmette-Guerin (BCG) vaccination and incidence of TB. Methods: Cross-sectional and longitudinal studies on HCWs, published in English until October 2013, comparing TST and QFT results, were selected. For each study Cohen's. value and a 95% confidence interval were calculated. Summary measures and indexes of heterogeneity between studies were calculated. Results: 29 studies were selected comprising a total of 11,434 HCWs. Cohen's. for agreement between TST and QFT for 24 of them was 0.28 (95% CI 0.22 to 0.35), with the best value in high TB incidence countries and the lowest rate of BCG vaccination. Conclusion: Currently, there is no gold standard for TB screening and the most-used diagnostic tools show low agreement. For evidence-based health surveillance in HCWs, occupational physicians need to consider a number of factors influencing screening results, such as TB incidence, vaccination status, age and working seniority.
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页数:13
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