Introduction
Methods
Study population and study design
Data retrieval
TST and QFT
Radiology
Statistical analyses
Results
Patient characteristics
Period of LTBI screening | ||||||
---|---|---|---|---|---|---|
(2000–2004) | (2005–2009) | (2010–2014) | (2015–2017) | All | ||
Characteristic | N = 22 | N = 93 | N = 117 | N = 63 | N = 295 | p value |
Age (year) | 53.6 ± 11.8 | 54.9 ± 11.9 | 54.5 ± 14.5 | 56.6 ± 15.0 | 55.0 ± 13.6 | 0.74 |
Sex (male) | 17/22 (77.3) | 51/93 (54.8) | 69/117 (59.0) | 37/63 (58.7) | 174/295 (59.0) | 0.30 |
Immigrant | 12/22 (54.5) | 36/93 (38.7) | 62/117 (53.0) | 36/63 (57.1) | 146/295 (49.5) | 0.09 |
TB history | 1/22 (4.5) | 17/93 (18.3) | 26/117 (22.2) | 12/63 (19.0) | 56/295 (19.0) | 0.28 |
Active TB, not treated | 0/22 (0) | 3/93 (3.2) | 4/117 (3.4) | 1/63 (1.6) | 8/295 (2.7) | 0.90 |
Latent TB, not treated | 1/22 (4.5) | 14/93 (15.1) | 22/117 (18.8) | 11/63 (17.5) | 48/295 (16.3) | 0.42 |
Travel to TB-endemic countrya | 8/22 (36.4) | 29/93 (31.2) | 51/117 (43.6) | 29/63 (46.0) | 117/295 (39.7) | 0.19 |
TB contact | 9/22 (40.9) | 32/93 (34.4) | 15/117 (12.8) | 11/63 (17.5) | 67/295 (22.7) | < 0.001 |
Risk group (any) | 3/22 (13.6) | 22/93 (23.7) | 24/117 (20.5) | 20/63 (31.7) | 69/295 (23.4) | 0.24 |
Alcohol abuse | 3/22 (13.6) | 4/93 (4.3) | 9/117 (7.7) | 3/63 (4.8) | 19/295 (6.4) | 0.34 |
Drug abuse | 1/22 (4.5) | 0/93 (0) | 1/117 (0.9) | 0/63 (0) | 2/295 (0.7) | 0.190 |
Homeless | 0/22 (0) | 0/93 (0) | 0/117 (0) | 0/63 (0) | 0/295 (0) | |
Prison inmate | 0/22 (0) | 0/93 (0) | 1/117 (0.9) | 5/63 (7.9) | 6/295 (2.0) | 0.009 |
Occupationalb | 0/0 (0) | 19/93 (20.4) | 15/117 (12.8) | 14/63 (22.2) | 48/295 (16.3) | 0.03 |
Comorbidities (any) | 21/22 (95.5) | 88/93 (94.6) | 112/117 (95.7) | 59/63 (93.7) | 280/295 (94.9) | 0.94 |
Auto-immune disease | 8/22 (36.4) | 72/93 (77.4) | 55/117 (47.0) | 31/63 (49.2) | 166/295 (56.3) | < 0.001 |
Chronic lung disease | 0/22 (0) | 3/93 (3.2) | 4/117 (3.4) | 7/63 (11.1) | 14/295 (4.7) | 0.11 |
Diabetes mellitus (type-2) | 4/22 (18.2) | 7/93 (7.5) | 17/117 (14.5) | 8/63 (12.7) | 36/295 (12.0) | 0.31 |
HIV | 0/22 (0) | 0/93 (0) | 0/117 (0) | 0/63 (0) | 0/295 (0) | |
Liver cirrhosis | 10/22 (45.5) | 12/93 (12.9) | 24/117 (20.5) | 7/63 (11.1) | 53/295 (18.0) | 0.003 |
Malignancy | 2/22 (9.1) | 4/93 (4.3) | 11/117 (9.4) | 6/63 (9.5) | 23/295 (9.5) | 0.44 |
Dialysis/chronic kidney failure | 1/22 (4.5) | 4/93 (4.3) | 29/117 (24.8) | 19/63 (30.2) | 53/295 (18.0) | < 0.001 |
Immunocompromised (at screening)c | 7/22 (31.8) | 50/93 (53.8) | 40/117 (34.2) | 26/63 (41.3) | 123/295 (41.7) | 0.031 |
BCG vaccinated | 9/22 (40.9) | 48/93 (51.6) | 61/117 (52.1) | 27/63 (42.9) | 145/295 (49.2) | 0.52 |
TST performed at time of screening | 22/22 (100) | 89/93 (95.7) | 96/117 (82.1) | 38/63 (60.3) | 245/295 (83.1) | < 0.001 |
QFT performed at time of screening | 8/22 (36.4) | 76/93 (81.7) | 98/117 (83.8) | 60/63 (95.2) | 242/295 (82.0) | < 0.001 |
Radiology | ||||||
Chest X-ray available | 21/22 (95.5) | 87/93 (93.5) | 108/117 (92.3) | 57/63 (90.5) | 273/295 (92.5) | 0.88 |
CT scan available | 5/22 (22.7) | 13/93 (14.0) | 41/117 (35.0) | 17/63 (27.0) | 76/295 (25.8) | 0.006 |
Contribution of different indicators of LTBI
TST and QFT
TST < 10 mm | TST ≥ 10 mm | All | QFT− | QFT+ | All | |||
---|---|---|---|---|---|---|---|---|
Characteristic | N = 47 | N = 198 | N = 245 | p value | N = 109 | N = 125 | N = 234 | p value |
Age (year) | 60.0 ± 14.6 | 52.4 ± 12.5 | 53.9 ± 13.2 | < 0.001 | 56.4 ± 13.2 | 54.4 ± 14.3 | 55.3 ± 13.8 | 0.27 |
Sex (male) | 26/47 (55.3) | 120/198 (60.6) | 146/245 (59.6) | 0.51 | 58/109 (53.2) | 75/125 (60.0) | 133/234 (56.8) | 0.30 |
Immigrant | 12/47 (25.5) | 110/198 (55.6) | 122/245 (49.8) | < 0.001 | 35/109 (32.1) | 73/125 (58.4) | 108/234 (46.2) | < 0.001 |
High TB-endemic country | 6/47 (12.8) | 55/198 (27.8) | 61/245 (24.9) | 0.03 | 17/109 (15.6) | 45/125 (34.2) | 62/234 (26.5) | 0.001 |
History of TB or LTBI | 7/47 (14.9) | 26/198 (13.1) | 33/245 (13.5) | 0.75 | 23/109 (21.1) | 23/125 (18.4) | 46/234 (19.7) | 0.60 |
Exposure | 15/47 (31.9) | 41/198 (20.7) | 56/245 (22.9) | 0.10 | 28/109 (25.7) | 28/125 (22.4) | 56/234 (23.9) | 0.56 |
IMID | 34/47 (72.3) | 109/198 (55.1) | 143/245 (58.4) | 0.03 | 83/109 (76.1) | 65/125 (52.0) | 148/234 (63.2) | < 0.001 |
Renal failure/dialysis | 5/47 (10.6) | 42/198 (21.2) | 47/245 (19.2) | 0.10 | 14/109 (12.8) | 21/125 (16.8) | 35/234 (15.0) | 0.40 |
Immunosuppressed | 27/47 (57.4) | 75/198 (37.9) | 102/245 (41.6) | 0.01 | 59/109 (54.1) | 46/125 (36.8) | 105/234 (44.9) | 0.008 |
Drug scorea | 0.65 ± 0.7 | 0.40 ± 0.6 | 0.45 ± 0.6 | 0.01 | 0.55 ± 0.6 | 0.41 ± 0.6 | 0.47 ± 0.6 | 0.08 |
BCG vaccination | 13/47 (27.7) | 109/198 (55.1) | 122/245 (49.8) | 0.001 | 45/109 (41.3) | 65/125 (52.0) | 110//234 (47.0) | 0.10 |
TST positivity | 69/95 (72.6) | 77/92 (83.7) | 146/187 (78.1) | 0.070 | ||||
TST induration (mm) | 11.7 ± 8.1 | 15.4 ± 9.6 | 13.5 ± 9.0 | 0.004 | ||||
QFT positivityb | 15/41 (36.6) | 77/146 (52.7) | 92/187 (49.2) | 0.08 | ||||
CXR-lesionsc | 26/45 (57.8) | 19/184 (10.3) | 45/229 (19.7) | < 0.001 | 29/102 (28.4) | 21/115 (18.3) | 50/209 (23.0) | 0.08 |
CT-lesionsd | 15/16 (93.8) | 22/35 (62.9) | 37/51 (72.5) | 0.04 | 19/22 (86.4) | 25/40 (62.5) | 44/62 (71.0) | 0.05 |
Tuberculin skin test result | ||||
---|---|---|---|---|
< 5 mm | 5–9 mm | ≥ 10 mm | All | |
QuantiFERON result | N = 29 | N = 12 | N = 146 | N = 187 |
< 0.15 IU/mL | 21 (72.4) | 4 (33.3) | 63 (43.2) | 88 (47.1) |
0.15–0.35 IU/mL | 1 (3.4) | 0 (0) | 6 (4.1) | 7 (3.7) |
≥ 0.35 IU/mL | 7 (24.1) | 8 (66.7) | 77 (52.7) | 92 (49.2) |
Radiography
CXR | CT | ||
---|---|---|---|
Characteristic | N = 273 | N = 76 | p value |
Lesions on chest imaginga | 62/273 (22.7) | 53/76 (69.7) | < 0.001 |
Calcified nodule | 19/273 (7.0) | 32/76 (42.1) | < 0.001 |
Non-calcified nodule | 17/273 (6.2) | 22/76 (28.9) | < 0.001 |
Fibrotic scarring | 9/273 (3.3) | 8/76 (10.5) | 0.007 |
Pleural thickening | 13/273 (4.8) | 7/76 (9.2) | 0.22 |
Other | 11/273 (4.0) | 3/76 (3.9) | 1.00 |
CXR-lesionsa | |||
---|---|---|---|
Negative | Positive | All | |
CT-lesionsb | N = 39 | N = 20 | N = 59 |
Negative | 18 (46.2) | 3 (15.0) | 21 (35.6) |
Positive | 21 (53.8) | 17 (85.0) | 38 (64.4) |