Diagnostic performance of T-SPOT test for pediatric tuberculosis

Abstract

Objective To investigate the diagnostic performance of T-SPOT test for pediatric tuberculosis (TB). Methods The results of T-SPOT and PPD in 67 TB children and 71 TB-excluded children that diagnosed and treated in the People's Hospital of Jianyang from June 2014 to May 2017 were retrospectively analyzed.The diagnostic efficacy and consistency of the two tests, and the diagnostic efficacy of combined examination were evaluated. Results The sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio, negative likelihood ratio, Youden′s index of T-SPOT were 88.1%, 94.4%, 93.7%, 89.3%, 15.6, 0.13, 0.83, respectively.While the above parameters of PPD were 68.7%, 74.6%, 71.9%, 71.6%, 2.71, 0.42, 0.43, respectively.T-SPOT had higher sensitivity, specificity, positive predictive value, negative predictive value compared with PPD, and the differences were statistically significant(χ2=7.44, 10.54, 10.51, 7.45, all P 0.05). The positive rate of T-SPOT was higher in 5-18 years old group than that in 0-4 years old group(95.1% vs.76.2 %, χ2=5.01, P 0.05). Conclusion T-SPOT outperformed PPD in diagnostic assistance of pediatric TB overall.The diagnostic superiority is noticeable in the>4-18 years old other than the 0-4 years old.Compared with T-SPOT alone, combined tests should not be regarded to have increased sensitivity. Key words: T-lymphocytes; Enzyme-linked immunospot assay; Tuberculosis, pulmonary; Mycobacterium tuberculosis; Tuberculin test; Diagnosis; Child