Journal Article

Large-Scale Evaluation of Enzyme-Linked Immunospot Assay and Skin Test for Diagnosis of <i>Mycobacterium tuberculosis</i> Infection against a Gradient of Exposure in The Gambia

Philip C. Hill, Roger H. Brookes, Annette Fox, Katherine Fielding, David J. Jeffries, Dolly Jackson-Sillah, Moses D. Lugos, Patrick K. Owiafe, Simon A. Donkor, Abdulrahman S. Hammond, Jacob K. Otu, Tumani Corrah, Richard A. Adegbola and Keith P. W. J. McAdam

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 38, issue 7, pages 966-973
Published in print April 2004 | ISSN: 1058-4838
Published online April 2004 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/382362
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

More Like This

Show all results sharing these subjects:

  • Infectious Diseases
  • Immunology
  • Public Health and Epidemiology
  • Microbiology

GO

Show Summary Details

Preview

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 (P = .011). Eighteen (31%) ESAT-6/CFP-10 ELISPOT–positive subjects in the lowest exposure category had negative 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.

Journal Article.  4053 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

Full text: subscription required

How to subscribe Recommend to my Librarian

Users without a subscription are not able to see the full content. Please, subscribe or login to access all content.