DSpace Repository

Impact of Reversion of Mycobacterium tuberculosis Immunoreactivity Tests on the Estimated Annual Risk of Infection.

Show simple item record

dc.contributor.author Schwalb Calderon, Alvaro
dc.contributor.author Emery, Jon C
dc.contributor.author Dale, Katie D
dc.contributor.author Horton, Katherine C
dc.contributor.author Ugarte Gil, Cesar Augusto
dc.contributor.author Houben, Rein M G J
dc.date.accessioned 2023-03-23T15:49:33Z
dc.date.available 2023-03-23T15:49:33Z
dc.date.issued 2023
dc.identifier.uri https://hdl.handle.net/20.500.12866/13273
dc.description.abstract A key metric in tuberculosis epidemiology is the annual risk of infection (ARI), which is usually derived from tuberculin skin test (TST) and interferon-gamma release assay (IGRA) prevalence surveys in children. Deriving the ARI assumes that immunoreactivity is persistent over time; however, reversion of immunoreactivity has long been documented. Here we use a deterministic, compartmental model of Mycobacterium tuberculosis (Mtb) infection to explore the impact of reversion on ARI estimation using age-specific reversion probabilities for TST and IGRA. Using empirical data of TST reversion (22.2%/year for 0-19yo), the true ARI is 2-5 times higher than estimated from immunoreactivity studies in 8-12 year-olds. Applying empirical reversion probabilities for IGRA (9.9%/year for 12-18yo) showed a 1.5-2-fold underestimation. ARIs are increasingly underestimated in older populations, due to the cumulative impact of reversion on population reactivity over time. Declines in annual risk did not largely affect the results. Ignoring reversion leads to a stark underestimation of the true ARI in populations and our interpretation of Mtb transmission intensity. Future surveys should adjust for reversion probabilities and its cumulative effect with increasing age to provide a more accurate reflection of the burden and dynamics of Mtb infection. en_US
dc.language.iso eng
dc.publisher Oxford University Press
dc.relation.ispartofseries American Journal of Epidemiology
dc.rights info:eu-repo/semantics/restrictedAccess
dc.rights.uri https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
dc.subject Tuberculin skin test en_US
dc.subject Interferon-gamma release assay en_US
dc.subject Mtb transmission en_US
dc.subject TST/IGRA surveys en_US
dc.subject.mesh Prueba de Tuberculina
dc.subject.mesh Ensayos de Liberación de Interferón gamma
dc.subject.mesh Mycobacterium tuberculosis
dc.subject.mesh Encuestas y Cuestionarios
dc.title Impact of Reversion of Mycobacterium tuberculosis Immunoreactivity Tests on the Estimated Annual Risk of Infection. en_US
dc.type info:eu-repo/semantics/article
dc.identifier.doi https://doi.org/10.1093/aje/kwad028
dc.relation.issn 1476-6256


Files in this item

Files Size Format View

There are no files associated with this item.

This item appears in the following Collection(s)

Show simple item record

info:eu-repo/semantics/restrictedAccess Except where otherwise noted, this item's license is described as info:eu-repo/semantics/restrictedAccess

Search DSpace


Browse

My Account

Statistics