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bioRxiv · 10.1101/343665

Comparative sensitivity of the test with tuberculosis recombinant allergen, containing ESAT6-CFP10 protein, and Mantoux test with 2 TU PPD-L in newly diagnosed tuberculosis children and adolescents in Moscow

Slogotskaya, L.·Bogorodskaya, E.·Ivanova, D.·Sevostyanova, T.
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Abstract

Background. A group of Russian scientists has developed Diaskintest, which comprises Mycobacterium tuberculosis-specific recombinant proteins CFP10-ESAT6, for skin testing (0.2 {micro}g/0.1 ml).\n\nStudy purpose: to evaluate the comparative sensitivity of TST with 2 TU PPD-L and a skin test with tuberculous recombinant allergen (Diaskintest) containing the ESAT6-CFP10 protein in children and adolescents with newly diagnosed respiratory tuberculosis during mass screening in the primary medical service in Moscow, 2013-2016.\n\nMaterials and methods. The trial was a comprehensive retrospective group study of children and adolescents diagnosed in Moscow with respiratory tuberculosis in 2013-2016, aged 0 to 17 years inclusive. From 441 patients selected for analysis 408 patients had both tests (TST with 2 TU PPD-L and Diaskintest) performed, in 193 patients both tests were given simultaneously, of them 162 patients were BCG-vaccinated.\n\nResults. Comparative results of both tests in 408 patients with tuberculosis: at cut-off 5 mm, both tests has similar sensitivity: Diaskintest 98.3 % (95 % CI 97.0-99.6 %), TST 98.0 % (95 % CI 96.7-99.4 %), at cut-off 10 mm, the sensitivity decreases for both tests: Diaskintest 90.0 % (95 % CI 87.0-93.0 %), TST 88.7 % (95 % CI 85.6-91.9 %), but at cut-off 15 mm, the decrease in sensitivity is statistically significant: for Diaskintest 61.5 % (95 % CI 56.7-66.3 %), and for TST 46.3 % (95 % CI 41.4-51.3 %), p <0.0001.\n\nThe results of simultaneous setting of tests on different hands in 193 people (including 162 BCG-vaccinated), do not differ from the results for 408 people.\n\nThe correlation between the results of Diaskintest and TST was significant in all groups.\n\nConclusion. In children and adolescents with respiratory tuberculosis, Diaskintest of 0.2 {micro}g/ml and the Mantoux test with 2 TU PPD-L have high sensitivity (98%) at a cut-off of 5 mm; however, at cut-off 15 mm sensitivity is significantly reduced, and the decrease is more pronounced in the Mantoux test. The advantage of Diaskintest is that, unlike the Mantoux test, it has high specificity under the conditions of mass BCG vaccination. The test is cost-effective, simple to carry out, and can be used in mass screening.

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Slogotskaya, L., Bogorodskaya, E., Ivanova, D., Sevostyanova, T.. 2018-06-11. Comparative sensitivity of the test with tuberculosis recombinant allergen, containing ESAT6-CFP10 protein, and Mantoux test with 2 TU PPD-L in newly diagnosed tuberculosis children and adolescents in Moscow. https://doi.org/10.1101/343665

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