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Войти в исследования International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases · 2026
Interferon-gamma release assays versus tuberculin skin test for latent tuberculosis infection positivity among healthcare workers and first responders: a systematic review and meta-analysis.
СтатьяСистематический обзорМетаанализСравнительное исследованиеНазвание и аннотация: Перевод в очереди
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Alahmari Hamoud, Hanson Lisa, Kelley Peter G, Spong Jo, Milazzo Adriana, Mnatzaganian George
Аннотация
OBJECTIVES: To estimate latent tuberculosis infection (LTBI) positivity among hospital healthcare workers (HCWs) and first responders.
METHODS: Four databases were searched for observational studies published from 2000 onward. Studies reporting LTBI positivity using interferon-gamma release assays (IGRAs) or tuberculin skin tests (TSTs) were included. Pooled proportions were estimated using Freeman-Tukey double arcsine transformation. Meta-regression used logit-transformed proportions with restricted maximum likelihood random-effects models. Estimates were stratified by diagnostic method and World Health Organization TB incidence region.
RESULTS: Of 34,835 records identified, 95 studies from 41 countries comprising 63,988 participants were included. The pooled IGRA and TST positivity proportions were 22% (95% CI: 17-28%) and 38% (95% CI: 31-44%), respectively. Among studies reporting both tests in the same populations, pooled positivity was 46% lower with IGRA than TST. The pooled IGRA and TST conversion proportions were 8% (95% CI: 6-12%) and 12% (95% CI: 7-18%), respectively. Unlike IGRA positivity, TST positivity was significantly associated with higher Bacillus Calmette-Guérin (BCG) vaccination rates.
CONCLUSION: LTBI remains common among HCWs, with estimates varying considerably by diagnostic method. Higher TST positivity, together with its association with BCG vaccination, suggests greater specificity of IGRA for LTBI screening in BCG-vaccinated populations.
METHODS: Four databases were searched for observational studies published from 2000 onward. Studies reporting LTBI positivity using interferon-gamma release assays (IGRAs) or tuberculin skin tests (TSTs) were included. Pooled proportions were estimated using Freeman-Tukey double arcsine transformation. Meta-regression used logit-transformed proportions with restricted maximum likelihood random-effects models. Estimates were stratified by diagnostic method and World Health Organization TB incidence region.
RESULTS: Of 34,835 records identified, 95 studies from 41 countries comprising 63,988 participants were included. The pooled IGRA and TST positivity proportions were 22% (95% CI: 17-28%) and 38% (95% CI: 31-44%), respectively. Among studies reporting both tests in the same populations, pooled positivity was 46% lower with IGRA than TST. The pooled IGRA and TST conversion proportions were 8% (95% CI: 6-12%) and 12% (95% CI: 7-18%), respectively. Unlike IGRA positivity, TST positivity was significantly associated with higher Bacillus Calmette-Guérin (BCG) vaccination rates.
CONCLUSION: LTBI remains common among HCWs, with estimates varying considerably by diagnostic method. Higher TST positivity, together with its association with BCG vaccination, suggests greater specificity of IGRA for LTBI screening in BCG-vaccinated populations.