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- Title
Large-Scale Evaluation of Enzyme-Linked Immunospot Assay and Skin Test for Diagnosis of Mycobacterium tuberculosis Infection against a Gradient of Exposure in The Gambia.
- Authors
Brookes, Roger H.; Fox, Annette; Fielding, Katherine; Jeffries, David J.; Jackson-Sillah, Dolly; Lugos, Moses D.; Owiafe, Patrick K.; Donkor, Simon A.; Hammond, Abdulrahman S.; Otu, Jacob K.; Corrah, Tumani; Adegbola, Richard A.; McAdam, Keith P. W. J.; Hill, Philip C.
- Abstract
The purified protein derivative (PPD) skin test for Mycobacterium tuberculosis infection lacks specificity. We assessed 2 more specific M. tuberculosis antigens (ESAT-6 and CFP-10) by enzyme-linked immunospot assay (ELISPOT) compared with PPD by ELISPOT and skin test in The Gambia. Of 735 household contacts of 130 sputum smear–positive tuberculosis cases, 476 (65%) tested positive by PPD ELISPOT, 300 (41%) tested positive by PPD skin test, and 218 (30%) tested positive by ESAT-6/CFP-10 ELISPOT. Only 15 (2%) had positive ESAT- 6/CFP-10 results and negative PPD results by ELISPOT. With increasing M. tuberculosis exposure, the percentage of subjects who were PPD skin test positive/ESAT-6/CFP-10 ELISPOT negative increased (P < .001) whereas the percentage of subjects who were PPD skin test negative/PPD ELISPOT positive decreased (Pp ). Eighteen (31%) SAT-6/CFP-10 ELISPOT–positive subjects in the lowest exposure category had negative .011 PPD skin test results. ESAT-6/CFP-10 ELISPOT probably offers increased specificity in the diagnosis of M. tuberculosis infection in this tropical setting of endemicity, at the cost of some sensitivity.
- Subjects
GAMBIA; MYCOBACTERIUM tuberculosis; SKIN tests; ENZYME-linked immunosorbent assay; BCG vaccines; DIAGNOSIS
- Publication
Clinical Infectious Diseases, 2004, Vol 38, Issue 7, p966
- ISSN
1058-4838
- Publication type
Article