{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,3]],"date-time":"2025-11-03T15:36:06Z","timestamp":1762184166386,"version":"build-2065373602"},"reference-count":25,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2025,10,31]],"date-time":"2025-10-31T00:00:00Z","timestamp":1761868800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Qingdao Medical and Health Research Program Project","award":["2023-WJZD128"],"award-info":[{"award-number":["2023-WJZD128"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["TropicalMed"],"abstract":"<jats:p>Background: Identifying latent tuberculosis infection (LTBI) is critical for pediatric TB control in China, especially among students from high-burden areas. With no gold-standard test, we compared the tuberculin skin test (TST) and interferon-gamma release assay (IGRA), focusing on factors related to test discordance. Materials and Methods: TST was administered to 1047 local and 900 migrant students; all migrants also received IGRA. TST cutoffs of 5 mm and 10 mm were applied. Agreement was measured using Cohen\u2019s Kappa, and determinants of discordance were analyzed with binary logistic regression. Results: Migrant students had higher TST positivity than locals (28.89% vs. 19.67%, p &lt; 0.001). The agreement between IGRA and TST-12 mm (k = 0.491) was higher than that observed for TST-10 mm (k = 0.466) and TST-5 mm (k = 0.356). Subgroup analyses across sex, residence, ethnicity, BMI, TB contact, and BCG history confirmed superior consistency for TST-12 mm. Individuals without BCG vaccination were less likely to show discordance between IGRA and TST-12 mm (OR = 0.32, 95% CI: 0.10\u20130.81). Conclusions: Using a 12 mm cutoff improves TST accuracy for students from high-burden areas. IGRA should be preferred for individuals with BCG vaccination history.<\/jats:p>","DOI":"10.3390\/tropicalmed10110311","type":"journal-article","created":{"date-parts":[[2025,11,3]],"date-time":"2025-11-03T14:00:33Z","timestamp":1762178433000},"page":"311","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Comparison of Interferon-Gamma Release Assay and Tuberculin Skin Test in Screening for Latent Tuberculous Infection Among Students from High-Burden Areas: A Prospective Head-to-Head Study in Qingdao, China"],"prefix":"10.3390","volume":"10","author":[{"given":"Zhongdong","family":"Wang","sequence":"first","affiliation":[{"name":"Qingdao Prefectural Center for Disease Control and Prevention, Qingdao Institute of Prevention Medicine, Qingdao 266000, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kun","family":"Zhang","sequence":"additional","affiliation":[{"name":"Beijing Key Laboratory for Key Technologies in Tuberculosis Prevention and Control, Department of Bacteriology and Immunology, Beijing Chest Hospital, Capital Medical University\/Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing 101149, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Haiyan","family":"Sun","sequence":"additional","affiliation":[{"name":"Qingdao Prefectural Center for Disease Control and Prevention, Qingdao Institute of Prevention Medicine, Qingdao 266000, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xuekui","family":"Li","sequence":"additional","affiliation":[{"name":"Qingdao Prefectural Center for Disease Control and Prevention, Qingdao Institute of Prevention Medicine, Qingdao 266000, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Song","family":"Song","sequence":"additional","affiliation":[{"name":"Qingdao Prefectural Center for Disease Control and Prevention, Qingdao Institute of Prevention Medicine, Qingdao 266000, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Meng","family":"Chen","sequence":"additional","affiliation":[{"name":"Qingdao Prefectural Center for Disease Control and Prevention, Qingdao Institute of Prevention Medicine, Qingdao 266000, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Honghong","family":"Xu","sequence":"additional","affiliation":[{"name":"Qingdao Prefectural Center for Disease Control and Prevention, Qingdao Institute of Prevention Medicine, Qingdao 266000, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6566-3468","authenticated-orcid":false,"given":"Huaqiang","family":"Zhang","sequence":"additional","affiliation":[{"name":"Qingdao Prefectural Center for Disease Control and Prevention, Qingdao Institute of Prevention Medicine, Qingdao 266000, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6803-9807","authenticated-orcid":false,"given":"Yu","family":"Pang","sequence":"additional","affiliation":[{"name":"Beijing Key Laboratory for Key Technologies in Tuberculosis Prevention and Control, Department of Bacteriology and Immunology, Beijing Chest Hospital, Capital Medical University\/Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing 101149, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaoqi","family":"Dai","sequence":"additional","affiliation":[{"name":"Qingdao Prefectural Center for Disease Control and Prevention, Qingdao Institute of Prevention Medicine, Qingdao 266000, China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,10,31]]},"reference":[{"key":"ref_1","unstructured":"World Health Organization (2025, October 26). Global Tuberculosis Report 2024, Available online: https:\/\/www.who.int\/teams\/global-tuberculosis-programme\/tb-reports\/global-tuberculosis-report-2024."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"S37","DOI":"10.1016\/j.ijid.2020.02.034","article-title":"Management of latent tuberculosis infection in China: Exploring solutions suitable for high-burden countries","volume":"92","author":"Cui","year":"2020","journal-title":"Int. J. Infect. Dis."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1900655","DOI":"10.1183\/13993003.00655-2019","article-title":"The global prevalence of latent tuberculosis: A systematic review and meta-analysis","volume":"54","author":"Cohen","year":"2019","journal-title":"Eur. Respir. J."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1186\/s40249-022-01046-z","article-title":"Transmissibility of tuberculosis among students and non-students: An occupational-specific mathematical modelling","volume":"11","author":"Chen","year":"2022","journal-title":"Infect. Dis. Poverty"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1186\/s40249-022-01009-4","article-title":"Age-period-cohort analysis of pulmonary tuberculosis reported incidence, China, 2006\u20132020","volume":"11","author":"Dong","year":"2022","journal-title":"Infect. Dis. Poverty"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"109132","DOI":"10.1016\/j.clim.2022.109132","article-title":"Positive rates of interferon-\u03b3 release assay and tuberculin skin test in detection of latent tuberculosis infection: A systematic review and meta-analysis of 200,000 head-to-head comparative tests","volume":"245","author":"Zhou","year":"2022","journal-title":"Clin. Immunol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1457","DOI":"10.1016\/S1473-3099(20)30276-0","article-title":"Interferon-\u03b3 release assays or tuberculin skin test for detection and management of latent tuberculosis infection: A systematic review and meta-analysis","volume":"20","author":"Zhou","year":"2020","journal-title":"Lancet Infect. Dis."},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Guo, J., Liu, C., Liu, F., Zhou, E., Ma, R., Zhang, L., and Luo, B. (2024). Tuberculosis disease burden in China: A spatio-temporal clustering and prediction study. Front. Public Health, 12.","DOI":"10.3389\/fpubh.2024.1436515"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1128\/CMR.00034-13","article-title":"Gamma interferon release assays for detection of Mycobacterium tuberculosis infection","volume":"27","author":"Pai","year":"2014","journal-title":"Clin. Microbiol. Rev."},{"key":"ref_10","unstructured":"National Health and Family Planning Commission of the People\u2019s Republic of China (2025, October 26). WS 288\u20142017 Diagnosis of Pulmonary Tuberculosis. 9 November 2017. Available online: https:\/\/www.chinesestandard.net\/PDF\/English.aspx\/WS288-2017."},{"key":"ref_11","unstructured":"World Health Organization (2025, October 26). WHO Consolidated Guidelines on Tuberculosis: Module 3: Diagnosis\u2014Tests for Tuberculosis Infection, Available online: https:\/\/www.who.int\/publications\/i\/item\/9789240056084."},{"key":"ref_12","unstructured":"General Office of the National Health Commission, General Office of the Ministry of Education (2025, October 26). Guidelines for the Prevention and Control of Tuberculosis in Chinese Schools. 4 December 2020, Available online: https:\/\/www.gov.cn\/zhengce\/zhengceku\/2020-12\/05\/5567137\/files\/85d293d4f3e04bacb420f252c2189278.pdf."},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"He, Y., Cao, X., Guo, T., He, Y., Du, Y., Zhang, H., Feng, B., Du, J., Zhang, B., and Wang, K. (2022). Serial testing of latent tuberculosis infection in patients with diabetes mellitus using interferon-gamma release assay, tuberculin skin test, and creation tuberculin skin test. Front. Public Health, 10.","DOI":"10.3389\/fpubh.2022.1025550"},{"key":"ref_14","first-page":"438","article-title":"Interpretation of the \u201cOperational Technical Specifications for the Two-Step Tuberculin Skin Test\u2013Interferon-Gamma Release Assay (TST\u2013IGRA)\u201d","volume":"44","author":"He","year":"2022","journal-title":"Chin. J. Antituberc."},{"key":"ref_15","first-page":"909","article-title":"Analysis on prevalence of latent tuberculosis in senior high school students from a western province in Qingdao, Shandong","volume":"39","author":"Dai","year":"2023","journal-title":"Dis. Surveill."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"159","DOI":"10.2307\/2529310","article-title":"The measurement of observer agreement for categorical data","volume":"33","author":"Landis","year":"1977","journal-title":"Biometrics"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"e3468","DOI":"10.1093\/cid\/ciaa1662","article-title":"Prevalence of Latent Tuberculosis Infection Among Non-US-Born Persons by Country of Birth-United States, 2012\u20132017","volume":"73","author":"Collins","year":"2021","journal-title":"Clin. Infect. Dis."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"321","DOI":"10.1016\/j.ijid.2022.06.010","article-title":"The effect of BCG vaccination and risk factors for latent tuberculosis infection among college freshmen in China","volume":"122","author":"Huang","year":"2022","journal-title":"Int. J. Infect. Dis."},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Sun, L., Qi, X., Guo, Y., Qi, H., Li, J., Wu, X., Yin, Q., Guo, Y., Xu, B., and Wang, Y. (2021). Tuberculosis infection screening in children with close contact: A hospital-based study. BMC Infect. Dis., 21.","DOI":"10.1186\/s12879-021-06480-2"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"704","DOI":"10.1183\/13993003.01910-2015","article-title":"Diagnostics for latent TB infection: Incremental, not transformative progress","volume":"47","author":"Pai","year":"2016","journal-title":"Eur. Respir. J."},{"key":"ref_21","first-page":"1192","article-title":"False-positive tuberculin skin tests: What is the absolute effect of BCG and non-tuberculous mycobacteria?","volume":"10","author":"Farhat","year":"2006","journal-title":"Int. J. Tuberc. Lung Dis."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"237","DOI":"10.1016\/j.advms.2017.12.001","article-title":"Do higher cut-off values for tuberculin skin test increase the specificity and diagnostic agreement with interferon gamma release assays in immunocompromised Bacillus Calmette-Gu\u00e9rin vaccinated patients?","volume":"63","author":"Erol","year":"2018","journal-title":"Adv. Med. Sci."},{"key":"ref_23","first-page":"363","article-title":"Selection of the cutoff value on tuberculin skin test in diagnosing tuberculosis infection: A population-based cross-sectional study in Eastern China","volume":"41","author":"Lu","year":"2020","journal-title":"Chin. J. Epidemiol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"787","DOI":"10.5588\/ijtld.13.0816","article-title":"Interferon-gamma release assays piloted as a latent tuberculous infection screening tool in Canadian federal inmates","volume":"18","author":"Schwartz","year":"2014","journal-title":"Int. J. Tuberc. Lung Dis."},{"key":"ref_25","unstructured":"World Health Organization (2025, October 26). WHO Operational Handbook on Tuberculosis (Module 1\u2014Prevention): Tuberculosis Preventive Treatment, Available online: https:\/\/apps.who.int\/iris\/bitstream\/handle\/10665\/331525\/9789240002906-eng.pdf."}],"container-title":["Tropical Medicine and Infectious Disease"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2414-6366\/10\/11\/311\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,3]],"date-time":"2025-11-03T14:50:51Z","timestamp":1762181451000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2414-6366\/10\/11\/311"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,31]]},"references-count":25,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2025,11]]}},"alternative-id":["tropicalmed10110311"],"URL":"https:\/\/doi.org\/10.3390\/tropicalmed10110311","relation":{},"ISSN":["2414-6366"],"issn-type":[{"value":"2414-6366","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10,31]]}}}