Madhukar Pai, MD, PhD; Alice Zwerling, MSc; and Dick Menzies, MD, MSc

Background: Interferon- γ –release assays (IGRAs) are alternatives to the tuberculin skin test (TST). A recent meta-analysis showed that IGRAs have high specificity, even among populations that have received bacille Calmette–Gue´ rin (BCG) vaccination. Sensitivity was suboptimal for TST and IGRAs.

Purpose: To incorporate newly reported evidence from 20 studies into an updated meta-analysis on the sensitivity and specificity of IGRAs.

Download this file (509_PUB_ART_Pai_Annals_2008.pdf)509_PUB_ART_Pai_Annals_2008.pdf[ ]253 kB

M. Pai,*† R. Joshi,‡§ S. Dogra,¶ A. A. Zwerling,*† D. Gajalakshmi,‡ K. Goswami,‡ M. V. R. Reddy,‡ S. Kalantri,‡ P. C. Hill,# D. Menzies,*† P. C. Hopewell**
*Department of Epidemiology and Biostatistics, McGill University, Montreal, †Respiratory Epidemiology & Clinical Research Unit, Montreal Chest Institute, Montreal, Quebec, Canada; ‡Mahatma Gandhi Institute of Medical Sciences, Sevagram, India; §Division of Epidemiology, School of Public Health,  University of California, Berkeley, California, USA; ¶ASC College of Medical Sciences & Hospital, Sidhra, Jammu, India; #Centre for International Health, University of Otago, Dunedin, New Zealand; **Division of Pulmonary & Critical Care Medicine, San Francisco General Hospital and University of California, San Francisco, California, USA

Download this file (510_PUB_ART_Pai_IJTLD_2009.pdf)510_PUB_ART_Pai_IJTLD_2009.pdf[ ]321 kB

on-Erik C. Holty,1,2 Michael K. Gould,1,2,4 Laura Meinke,5 Emmet B. Keeffe,3 and Stephen J. Ruoss2 1Center for Primary Care and Outcomes Research, Stanford University, Stanford, CA; Divisions of 2Pulmonary and Critical Care Medicine and 3Gastroenterology and Hepatology, Department of Medicine, Stanford University School of Medicine, Stanford, CA; 4VA Palo Alto Health Care System, Palo Alto, CA; and 5Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of Arizona, Tucson, AZ

Richard N. van Zyl-Smit1, Madhukar Pai2, Kwaku Peprah1, Richard Meldau1, Jackie Kieck3, June Juritz4, Motasim Badri1, Alimuddin Zumla5, Leonardo A. Sechi6, Eric D. Bateman1, and Keertan Dheda1,5,7

1Lung Infection and Immunity Unit, Division of Pulmonology and UCT Lung Institute Department of Medicine, University of Cape Town, Cape Town, South Africa; 2Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Canada; 3Department of Radiology, University of Cape Town and Groote Schuur Hospital, and 4Department of Statistical Sciences, University of Cape Town, Cape Town, South Africa; 5Centre for Infectious Diseases and International Health, Royal Free and University College Medical School, London, United Kingdom; 6Dipartimento di Scienze Biomediche, University of Sardinia, Sassari, Italy; and 7Institute of Infectious Diseases and Molecular Medicine, University of Cape Town, Cape Town, South Africa

Thomas Haustein, MD,*†‡ Deborah A. Ridout, MSc,§ John C. Hartley, FRCPath,*†‡ Urvashi Thaker, MSc,*†‡ Delane Shingadia, FRCPCH, MPH,¶ Nigel J. Klein, PhD,¶ Vas Novelli, FRCP,¶ and Garth L. J. Dixon, PhD*†‡

Tuberculosis continues to be the world's most important infectious cause of morbity and mortality among adulsts. Nearly 9 million people develop TB disease each year, and an estimated 1.6 million die from the disease.Despite this enormous global burden, case detection rates are low, posing an enormous hurdle for TB control. Conventional TB diagnosis approaches continue to rely on century-old tests, such as sputum smear microscopy, solid media culture, tuberculin skin tests, and chest radiography. These tests have several limitations and perform quite poorly in populations affected by the HIV epidemic. For example, sputum smear microscopy using standard direct Ziehl-Neelsen (ZN) sttaing has low sensitivity in HIV-infected individuasl and, by definition, it is of no value in smear-negative TB. Smear microscopy is also unhelpful in many cases of extrapulmonary TB and childhood TB.

Sobre a REDE-TB

A Rede Brasileira de Pesquisa em Tuberculose (REDE-TB) é uma Organização Não Governamental (ONG) de direito privado sem fins lucrativos, preocupada em auxiliar no desenvolvimento não só de novos medicamentos, novas vacinas, novos testes diagnósticos e novas estratégias de controle de TB, mas também na validação dessas inovações tecnológicas, antes de sua comercialização no país e/ou de sua implementação nos Programa de Controle de TB no País.




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