[New recommendations for contact tracing in tuberculosis].
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[New recommendations for contact tracing in tuberculosis]. / Diel, R; Loytved, G; Nienhaus, Albert; Castell, S; Detjen, A; Geerdes-Fenge, H; Haas, W; Hauer, B; Königstein, B; Maffei, D; Magdorf, K; Priwitzer, M; Zellweger, J-P; Loddenkemper, R.
In: GESUNDHEITSWESEN, Vol. 73, No. 6, 6, 2011, p. 369-388.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - [New recommendations for contact tracing in tuberculosis].
AU - Diel, R
AU - Loytved, G
AU - Nienhaus, Albert
AU - Castell, S
AU - Detjen, A
AU - Geerdes-Fenge, H
AU - Haas, W
AU - Hauer, B
AU - Königstein, B
AU - Maffei, D
AU - Magdorf, K
AU - Priwitzer, M
AU - Zellweger, J-P
AU - Loddenkemper, R
PY - 2011
Y1 - 2011
N2 - In 2007, the German Central Committee against Tuberculosis (DZK) published recommendations for contact tracing that introduced the new interferon gamma release assays (IGRAs). Meanwhile, substantial progress has been made in documenting the utility of IGRAs. Because IGRAs are usually superior to the tuberculin skin test (TST) in detecting latent TB infection (LTBI) with respect to sensitivity and specificity in adult contact populations that are at least partially BCG vaccinated, it is now recommended that instead of two-step testing only IGRAs be used.[nl]As the literature does not yet provide sufficient data on the accuracy of IGRAs in children younger than 5 years, the TST remains the method of choice in that age group. To date, also, no clear body of data exists to substantiate better performance for IGRAs than for the TST in older children, thus in this age group using of either test is recommended. The new recommendations also underscore the importance of a diligent preselection of close contacts in order to achieve a high probability that positive test results represent recent infection and to thus increase the benefit of chemopreventive treatment for those identified as requiring it. In a third point of update, it is noted that re-testing of contacts individuals found positive for LTBI may produce a considerable number of false-negative results and should thus be avoided in case of documented exposure.
AB - In 2007, the German Central Committee against Tuberculosis (DZK) published recommendations for contact tracing that introduced the new interferon gamma release assays (IGRAs). Meanwhile, substantial progress has been made in documenting the utility of IGRAs. Because IGRAs are usually superior to the tuberculin skin test (TST) in detecting latent TB infection (LTBI) with respect to sensitivity and specificity in adult contact populations that are at least partially BCG vaccinated, it is now recommended that instead of two-step testing only IGRAs be used.[nl]As the literature does not yet provide sufficient data on the accuracy of IGRAs in children younger than 5 years, the TST remains the method of choice in that age group. To date, also, no clear body of data exists to substantiate better performance for IGRAs than for the TST in older children, thus in this age group using of either test is recommended. The new recommendations also underscore the importance of a diligent preselection of close contacts in order to achieve a high probability that positive test results represent recent infection and to thus increase the benefit of chemopreventive treatment for those identified as requiring it. In a third point of update, it is noted that re-testing of contacts individuals found positive for LTBI may produce a considerable number of false-negative results and should thus be avoided in case of documented exposure.
KW - Germany
KW - Humans
KW - Risk Factors
KW - Child
KW - Predictive Value of Tests
KW - Child, Preschool
KW - BCG Vaccine/administration & dosage
KW - Contact Tracing/methods
KW - Interferon-gamma Release Tests
KW - Latent Tuberculosis/diagnosis/transmission
KW - Opportunistic Infections/diagnosis/transmission
KW - Tuberculin Test
KW - Germany
KW - Humans
KW - Risk Factors
KW - Child
KW - Predictive Value of Tests
KW - Child, Preschool
KW - BCG Vaccine/administration & dosage
KW - Contact Tracing/methods
KW - Interferon-gamma Release Tests
KW - Latent Tuberculosis/diagnosis/transmission
KW - Opportunistic Infections/diagnosis/transmission
KW - Tuberculin Test
M3 - SCORING: Zeitschriftenaufsatz
VL - 73
SP - 369
EP - 388
JO - GESUNDHEITSWESEN
JF - GESUNDHEITSWESEN
SN - 0941-3790
IS - 6
M1 - 6
ER -
