Comparative performance of QuantiFERON-TB Gold versus skin test with tuberculosis recombinant allergen (Diaskintest) among patients with suspected pulmonary tuberculosis in Russia

Background: The early identification of Mycobacterium tuberculosis infection can prevent tuberculosis (TB) transmission. A skin test with a tuberculosis recombinant allergen (Diaskintest) is a new method for identification that has been implemented in Russia. This study was performed to compare the performances of Diaskintest and QuantiFERON-TB Gold (QFT) in adults and children with suspected TB in Moscow, Russia. Methods: Adults (n = 85) and children (n = 96) were tested using Diaskintest and QFT. Concordance and comparative analyses were performed. Results: Diaskintest and QFT were concordant in 84% of adults and 90% of children (overall concordance 87%, kappa > 0.6, K-c > 0.5). The concordance between QFT, Diaskintest, and the final diagnosis was good in adults (86% and 81%, respectively) and moderate in children (77% and 79%, respectively). In adults, QFT had a higher sensitivity for detecting TB than Diaskintest (82% and 68%, respectively); in children, Diaskintest was more sensitive (73% and 65%, respectively). In patients with a confirmed TB diagnosis, negative Diaskintest/QFT results were associated with low disease activity. Combined Diaskintest/QFT results identified TB patients with higher sensitivity and specificity than each test separately. Conclusions: Diaskintest is a low-cost diagnostic tool that shows a test positivity rate similar to QFT and can be used in combination with QFT as an adjunctive test for TB diagnosis. (C) 2019 The Author(s). Published by Elsevier Ltd on behalf of International Society for Infectious Diseases.