{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T06:36:41Z","timestamp":1789540601641,"version":"build-2803163510"},"reference-count":42,"publisher":"MDPI AG","issue":"16","license":[{"start":{"date-parts":[[2019,8,14]],"date-time":"2019-08-14T00:00:00Z","timestamp":1565740800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001322","name":"South African Medical Research Council","doi-asserted-by":"publisher","award":["RFA-EMU-02-2017"],"award-info":[{"award-number":["RFA-EMU-02-2017"]}],"id":[{"id":"10.13039\/501100001322","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001713","name":"European and Developing Countries Clinical Trials Partnership","doi-asserted-by":"publisher","award":["TMA-2015SF-1043 & TMA- 1051-TESAII"],"award-info":[{"award-number":["TMA-2015SF-1043 & TMA- 1051-TESAII"]}],"id":[{"id":"10.13039\/501100001713","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001713","name":"European and Developing Countries Clinical Trials Partnership","doi-asserted-by":"publisher","award":["EDCTP TB NEAT: IP_09_32040_009"],"award-info":[{"award-number":["EDCTP TB NEAT: IP_09_32040_009"]}],"id":[{"id":"10.13039\/501100001713","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["IU2RTW007370-01A1"],"award-info":[{"award-number":["IU2RTW007370-01A1"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R24 TW007988-03"],"award-info":[{"award-number":["R24 TW007988-03"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Background: Given the lack of a gold standard for latent tuberculosis infection (LTBI) and paucity of performance data from endemic settings, we compared test performance of the tuberculin skin test (TST) and two interferon-gamma-release assays (IGRAs) among health-care workers (HCWs) using latent class analysis. The study was conducted in Cape Town, South Africa, a tuberculosis and human immunodeficiency virus (HIV) endemic setting Methods: 505 HCWs were screened for LTBI using TST, QuantiFERON-gold-in-tube (QFT-GIT) and T-SPOT.TB. A latent class model utilizing prior information on test characteristics was used to estimate test performance. Results: LTBI prevalence (95% credible interval) was 81% (71\u201388%). TST (10 mm cut-point) had highest sensitivity (93% (90\u201396%)) but lowest specificity (57%, (43\u201371%)). QFT-GIT sensitivity was 80% (74\u201391%) and specificity 96% (94\u201398%), and for TSPOT.TB, 74% (67\u201384%) and 96% (89\u201399%) respectively. Positive predictive values were high for IGRAs (90%) and TST (99%). All tests displayed low negative predictive values (range 47\u201366%). A composite rule using both TST and QFT-GIT greatly improved negative predictive value to 90% (range 80\u201397%). Conclusion: In an endemic setting a positive TST or IGRA was highly predictive of LTBI, while a combination of TST and IGRA had high rule-out value. These data inform the utility of LTBI-related immunodiagnostic tests in TB and HIV endemic settings.<\/jats:p>","DOI":"10.3390\/ijerph16162912","type":"journal-article","created":{"date-parts":[[2019,8,15]],"date-time":"2019-08-15T04:22:54Z","timestamp":1565842974000},"page":"2912","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["Evaluating Latent Tuberculosis Infection Test Performance Using Latent Class Analysis in a TB and HIV Endemic Setting"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3630-1855","authenticated-orcid":false,"given":"Shahieda","family":"Adams","sequence":"first","affiliation":[{"name":"School of Public Health and Family Medicine, Division of Occupational Medicine, University of Cape Town, Observatory 7925, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rodney","family":"Ehrlich","sequence":"additional","affiliation":[{"name":"School of Public Health and Family Medicine, Division of Occupational Medicine, University of Cape Town, Observatory 7925, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roslynn","family":"Baatjies","sequence":"additional","affiliation":[{"name":"Department of Environmental and Occupational Studies, Faculty of Applied Sciences, Cape Peninsula University of Technology, Cape Town 8000, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nandini","family":"Dendukuri","sequence":"additional","affiliation":[{"name":"Division of Clinical Epidemiology, McGill University Health Centre\u2014Research Institute, Montreal, QC H4A 3J1, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8940-8226","authenticated-orcid":false,"given":"Zhuoyu","family":"Wang","sequence":"additional","affiliation":[{"name":"Division of Clinical Epidemiology, McGill University Health Centre\u2014Research Institute, Montreal, QC H4A 3J1, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keertan","family":"Dheda","sequence":"additional","affiliation":[{"name":"Centre for Lung Infection and Immunity, Division of Pulmonology, Department of Medicine and UCT Lung Institute &amp; South African MRC\/UCT Centre for the Study of Antimicrobial Resistance, University of Cape Town, Observatory, Cape Town 7925, South Africa"},{"name":"Faculty of Infectious and Tropical Diseases, Department of Immunology and Infection, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2019,8,14]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1211","DOI":"10.1016\/S0140-6736(15)00151-8","article-title":"Tuberculosis","volume":"387","author":"Dheda","year":"2016","journal-title":"Lancet"},{"key":"ref_2","unstructured":"World Health Organization (2018). 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