Progress in the detection of latent tuberculosis infection
10.19428/j.cnki.sjpm.2025.24611
- VernacularTitle:结核潜伏感染检测方法的研究进展
- Author:
Shuang ZHANG
1
;
Hong ZHAO
2
;
Meixia YANG
3
Author Information
1. School of Public Health, Fudan University, Shanghai 200032, China
2. School of Public Health, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
3. Xuhui District Center for Disease Control and Prevention, Shanghai 200237, China
- Publication Type:Review
- Keywords:
latent tuberculosis infection;
screening;
tuberculin skin test;
interferon-γ release assay;
recombinant Mycobacterium tuberculosis fusion protein skin test;
meta-analysis
- From:
Shanghai Journal of Preventive Medicine
2025;37(1):94-99
- CountryChina
- Language:Chinese
-
Abstract:
ObjectiveTo introduce the three main techniques for tuberculosis screening currently used in China, to systematically evaluate their accuracy in diagnosing latent tuberculosis infection (LTBI), so as to provide scientific basis and recommendations for the formulation of China’s tuberculosis screening strategy. MethodsLiterature on the diagnosis of tuberculosis by tuberculin skin test (TST), interferon-γ release assay (IGRA), and recombinant Mycobacterium tuberculosis fusion protein (EC) skin test from January 1, 2010 to August 22, 2024 was comprehensively retrieved from PubMed, China National Knowledge Infrastructure (CNKI), and Wanfang Database through computerized search. Besides, all the literature was screened in accordance to the inclusion criteria for diagnostic tests, and characteristic information of the literature selected was extracted simultaneously. Meta-analysis was performed using Stata 17.0 software, with a random-effects model used for weighted quantitative synthesis of included literature, calculating pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and their 95% confidence intervals (CI). ResultsA total of 543 relevant articles were retrieved, with 105 ultimately included. Among them, 33 articles reported diagnostic data for TST, with a pooled sensitivity of 0.68 (95%CI: 0.62‒0.73), specificity of 0.67 (95%CI: 0.60‒0.73), positive likelihood ratio of 2.0 (95%CI: 1.7‒2.5), and negative likelihood ratio of 0.48 (95%CI: 0.40‒0.58). Ninety-four articles reported the diagnostic value of IGRAs test, with a pooled sensitivity of 0.88 (95%CI: 0.87‒0.89), specificity of 0.82 (95%CI: 0.79‒0.84), positive likelihood ratio of 4.8 (95%CI: 4.2‒5.6), and negative likelihood ratio of 0.15 (95%CI: 0.13‒0.17). Data on EC skin test was limited, but preliminary analysis showed that it had high sensitivity and specificity. ConclusionIGRA has a significant advantage in diagnosing LTBI, and EC skin test also shows good diagnostic performance, although relevant data is limited. TST remains suitable for large-scale screening due to its cost-effectiveness.
