Use of T Cell–Based Diagnosis of Tuberculosis Infection to Optimize Interpretation of Tuberculin Skin Testing for Child Tuberculosis Contacts

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Abstract
Background. Treatment of recent tuberculosis infection in children aged Methods. A total of 979 child tuberculosis contacts in Istanbul underwent the TST and enzyme-linked immunospot assay. Using enzyme-linked immunospot test results as a reference standard, we assessed the effect of age and bacille Calmette-Guérin (BCG) vaccination on the sensitivity and specificity of the TST, and we computed the optimal TST cutoff points, using receiver operating characteristic curves. Results. With a TST cutoff point of ⩾10 mm, the sensitivity of the TST was 66% for children aged Conclusions. Negative results of the TST cannot exclude tuberculosis infection for child tuberculosis contacts aged 1 BCG scar. This methodology can define optimal TST cutoff points for diagnosis of tuberculosis infection tailored to target populations.

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