Effect of BCG vaccination and non-tuberculous Mycobacterium infection on interferon gamma specific assay and a tuberculin skin test among children with a tuberculosis contact in Surabaya, Indonesia.

Abstract

The tuberculin skin test (TST) as a diagnostic tool for tuberculosis (TB) infection is used in many countries, including Indonesia, but lacks specificity. Interferon-gamma is a highly specific assay because it is not influenced by previous BCG vaccination or non-tuberculous mycobacteria (NTM) infections. We aimed to study the effect of BCG vaccination and NTM infection on the results of the interferon-gamma specific assay and TST among children with a TB contact. We carried out a cross-sectional study of children at an outpatient clinic in Surabaya, Indonesia. We studied 37 children aged 1-15 years having a household contact with an acid-fast bacilli positive adult index case. BCG vaccination was determined by the presence of a BCG scar. A PPD RT23 2 tuberculin test was used for the TST. ESAT-6, CFP-10, and TB 7.7(p4) antigens were used for the interferon-gamma assay by ELISA. Gastric aspirates were cultured in Lowenstein-Jensen media. A comparison of the two diagnostic tools among children aged 1-5 years without a BCG scar, revealed high agreement, while children with a BCG scar it revealed disagreement. Among children aged > 5 years with or without a BCG scar the comparisons revealed disagreement. Among children aged > 5-10 years, a comparison of the two diagnostic tools among NTM positive and negative children, there was a disagreement in results. Among children aged 1-5 years, the TST was influenced by a BCG scar. Infection with NTM had no influence on the results of the TST among children aged > 5-10 years, while in children aged 1-5 years and > 10 years the results could not be determined in this study.

• Authors: Landia Setiawati, Anang Endaryanto, Annie Kusumadewi, Pudji Lestari
• Journal: The Southeast Asian journal of tropical medicine and public health (Southeast Asian J Trop Med Public Health) Vol. 42 Issue 6 Pg. 1460-8 (Nov 2011) ISSN: 0125-1562 [Print] Thailand
• PMID: 22299416 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• BCG Vaccine
• Interferon-gamma

Topics

• Adolescent
• BCG Vaccine
• Child
• Child, Preschool
• Cross-Sectional Studies
• Enzyme-Linked Immunosorbent Assay
• Female
• Humans
• Indonesia (epidemiology)
• Infant
• Interferon-gamma
• Male
• Mycobacterium Infections, Nontuberculous (diagnosis, epidemiology, immunology)
• Tuberculin Test
• Tuberculosis (immunology, transmission)