{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T08:57:15Z","timestamp":1790326635291,"version":"4.1.0"},"reference-count":44,"publisher":"Oxford University Press (OUP)","issue":"7","license":[{"start":{"date-parts":[[2015,4,1]],"date-time":"2015-04-01T00:00:00Z","timestamp":1427846400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2015,4,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Rationale<\/jats:title>\n                    <jats:p>Children who are young, malnourished, and infected with HIV have significant risk of tuberculosis (TB) morbidity and mortality following TB infection. Treatment of TB infection is hindered by poor detection and limited pediatric data.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Identify improved testing to detect pediatric TB infection.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This was a prospective community-based study assessing use of the tuberculin skin test and IFN-\u03b3 release assays among children (n\u2009=\u20091,343; 6 mo to &amp;lt;15 yr) in TB-HIV high-burden settings; associations with child characteristics were measured.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Measurements and Main Results<\/jats:title>\n                    <jats:p>Contact tracing detects TB in 8% of child contacts within 3 months of exposure. Among children with no documented contact, tuberculin skin test and QuantiFERON-TB Gold In-Tube positivity was greater than T-SPOT.TB. Nearly 8% of children had IFN-\u03b3 release assay positive and skin test negative discordance. In a model accounting for confounders, all tests correlate with TB contact, but IFN-\u03b3 release assays correlate better than the tuberculin skin test (P\u2009=\u20090.0011). Indeterminate IFN-\u03b3 release assay results were not associated with age. Indeterminate QuantiFERON-TB Gold In-Tube results were more frequent in children infected with HIV (4.7%) than uninfected with HIV (1.9%), whereas T-SPOT.TB indeterminates were rare (0.2%) and not affected by HIV status. Conversion and reversion were not associated with HIV status. Among children infected with HIV, tests correlated less with contact as malnutrition worsened.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Where resources allow, use of IFN-\u03b3 release assays should be considered in children who are young, recently exposed, and infected with HIV because they may offer advantages compared with the tuberculin skin test for identifying TB infection, and improve targeted, cost-effective delivery of preventive therapy. Affordable tests of infection could dramatically impact global TB control.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1164\/rccm.201406-1165oc","type":"journal-article","created":{"date-parts":[[2015,1,26]],"date-time":"2015-01-26T12:54:34Z","timestamp":1422276874000},"page":"820-830","source":"Crossref","is-referenced-by-count":43,"title":["Optimizing the Detection of Recent Tuberculosis Infection in Children in a High Tuberculosis\u2013HIV Burden Setting"],"prefix":"10.1093","volume":"191","author":[{"given":"Anna M.","family":"Mandalakas","sequence":"first","affiliation":[{"name":"Section on Retrovirology and Global Health, Department of Pediatrics, Baylor College of Medicine, Houston, Texas"},{"name":"The Global TB Program, Texas Children\u2019s Hospital, Houston, Texas"},{"name":"Desmond Tutu TB Centre, Department of Paediatrics and Child Health, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H. Lester","family":"Kirchner","sequence":"additional","affiliation":[{"name":"Center for Health Research, Geisinger Clinic, Danville, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gerhard","family":"Walzl","sequence":"additional","affiliation":[{"name":"DST\/NRF Centre of Excellence for Biomedical Tuberculosis Research and MRC Centre for TB Research, Division of Molecular Biology and Human Genetics, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert P.","family":"Gie","sequence":"additional","affiliation":[{"name":"Desmond Tutu TB Centre, Department of Paediatrics and Child Health, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H. 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