1
|
Hernanz Lobo A, Berzosa Sánchez A, Escolano L, Pérez Muñoz S, Gerig N, Sainz T, Mellado Peña MJ, García López Hortelano M. International Adoption of Children with Special Needs in Spain. CHILDREN (BASEL, SWITZERLAND) 2023; 10:children10040690. [PMID: 37189939 DOI: 10.3390/children10040690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 03/30/2023] [Accepted: 03/31/2023] [Indexed: 05/17/2023]
Abstract
International adoption has declined in recent years, although the adoption of children with special needs has arisen. We aim to describe our experience in the international adoption of children with special needs and to analyze the concordance between the pathologies included in pre-adoption reports and the diagnosis made upon arrival. We conducted a retrospective descriptive study including internationally adopted children with special needs evaluated at a reference Spanish unit between 2016 and 2019. Epidemiological and clinical variables were collected from medical records, and pre-adoption reports were compared to established diagnoses following their evaluation and complementary tests. Fifty-seven children were included: 36.8% females, a median age of 27 months [IQR:17-39], mostly coming from China (63.2%) and Vietnam (31.6%). The main pathologies described in the pre-adoption reports were congenital surgical malformations (40.3%), hematological (22.6%), and neurological (24.6%). The initial diagnosis that motivated the international adoption via special needs was confirmed in 79% of the children. After evaluation, 14% were diagnosed with weight and growth delay, and 17.5% with microcephaly, not previously reported. Infectious diseases were also prevalent (29.8%). According to our series, the pre-adoption reports of children with special needs appear accurate, with a low rate of new diagnoses. Pre-existing conditions were confirmed in almost 80% of cases.
Collapse
Affiliation(s)
- Alicia Hernanz Lobo
- Pediatric Infectious Diseases Department, Gregorio Marañón University Hospital, 28007 Madrid, Spain
- Gregorio Marañón Research Health Institute (IiSGM), Translational Research in Pediatric Infectious Diseases (RITIP), 28007 Madrid, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFECC), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Medicine Faculty, Complutense University of Madrid, 28040 Madrid, Spain
| | - Arantxa Berzosa Sánchez
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFECC), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Medicine Faculty, Complutense University of Madrid, 28040 Madrid, Spain
- Department of Pediatrics, Clínico San Carlos Hospital, Clínico San Carlos Research Health Institute (IdISSC), 28040 Madrid, Spain
| | - Lucía Escolano
- Department of Pediatrics, La Paz University Hospital, 28046 Madrid, Spain
| | - Sara Pérez Muñoz
- Department of Pediatrics, Torrejon Hospital, 28850 Madrid, Spain
| | - Nathalia Gerig
- Department of Pediatrics, La Paz University Hospital, 28046 Madrid, Spain
| | - Talía Sainz
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFECC), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Department of Pediatrics, Infectious and Tropical Diseases, Paediatrics, La Paz University Hospital, Paseo de la Castellana, 261, 28046 Madrid, Spain
- La Paz Hospital and La Paz Research Institute (IdiPAZ), Translational Research in Pediatric Infectious Diseases (RITIP), 28046 Madrid, Spain
- Medicine Faculty, Autónoma University of Madrid, 28049 Madrid, Spain
| | - María Jose Mellado Peña
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFECC), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Department of Pediatrics, Infectious and Tropical Diseases, Paediatrics, La Paz University Hospital, Paseo de la Castellana, 261, 28046 Madrid, Spain
- La Paz Hospital and La Paz Research Institute (IdiPAZ), Translational Research in Pediatric Infectious Diseases (RITIP), 28046 Madrid, Spain
- Medicine Faculty, Autónoma University of Madrid, 28049 Madrid, Spain
| | - Milagros García López Hortelano
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFECC), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Department of Pediatrics, Infectious and Tropical Diseases, Paediatrics, La Paz University Hospital, Paseo de la Castellana, 261, 28046 Madrid, Spain
- La Paz Hospital and La Paz Research Institute (IdiPAZ), Translational Research in Pediatric Infectious Diseases (RITIP), 28046 Madrid, Spain
- Medicine Faculty, Autónoma University of Madrid, 28049 Madrid, Spain
| |
Collapse
|
2
|
Goutines J, Miller LC, Sorge F. Infections and nutritional status of internationally adopted children in France. Acta Paediatr 2021; 110:1359-1365. [PMID: 33040353 DOI: 10.1111/apa.15612] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2020] [Revised: 08/16/2020] [Accepted: 10/05/2020] [Indexed: 11/28/2022]
Abstract
AIM In the context of global changes in the epidemiology of internationally adopted children (IACs), the prevalence of infectious diseases and nutritional impairment has not been recently reviewed. Moreover, in France, these characteristics of the children according to their continents of origin and preadoption special needs (SN) status have been incompletely explored. METHODS Demographic, infectious data and anthropometric of all the newly arrived IACs seen in a specialised clinic for international adoptees in Paris, France, between 2013 and 2016 were retrospectively reviewed. RESULTS Three hundred and fifty IACs [mean age: 3.4 years (±2.7), 204 male] from 39 countries were included; 55% had SN. Ninety-nine patients had at least one infection, 42% being classified as 'serious' (chronic viral infection, tuberculosis or malaria). Chronic viral infection was diagnosed in 26 (7%) patients (HIV: 16 cases, HBV: 5, HCV: 4) and affected especially Asian children (P < .001). The prevalence of stunting, underweight, wasting and microcephaly was, respectively, 25%, 22%, 15% and 8%. Stunting was more frequent in children from Eastern Europe (P = .02), while SN children were more often microcephalic or underweight (respectively P = .03 and .02). CONCLUSION The prevalence of serious infections and nutritional impairment remains high in IACs and requires early detection and careful follow-up.
Collapse
Affiliation(s)
- Juliette Goutines
- Department of Paediatrics Necker‐Enfants‐Malades University Hospital Paris France
| | - Laurie C. Miller
- Department of Paediatrics Necker‐Enfants‐Malades University Hospital Paris France
| | - Frederic Sorge
- Department of Paediatrics Necker‐Enfants‐Malades University Hospital Paris France
| |
Collapse
|
3
|
Salami B, Fernandez-Sanchez H, Fouche C, Evans C, Sibeko L, Tulli M, Bulaong A, Kwankye SO, Ani-Amponsah M, Okeke-Ihejirika P, Gommaa H, Agbemenu K, Ndikom CM, Richter S. A Scoping Review of the Health of African Immigrant and Refugee Children. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:3514. [PMID: 33800663 PMCID: PMC8038070 DOI: 10.3390/ijerph18073514] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 03/18/2021] [Accepted: 03/22/2021] [Indexed: 12/02/2022]
Abstract
Migration is a growing phenomenon around the world, including within the African continent. Many migrants, especially African children, face challenges related to health and social inclusion and can face increased health risks. A systematic scoping review of available literature on the health of African migrant children across the globe was conducted to offer insight into these health risks. The review was conducted over a 15-month period from January 2019 to April 2020, yielding 6602 articles once duplicates were removed. This search included electronic databases, reference lists of articles reviewed, and searches of libraries of relevant organisations. A total of 187 studies met the inclusion criteria, of which 159 were quantitative, 22 were qualitative, and 6 used mixed methods. The findings reveal decreased health in this population in areas of nutrition, infectious diseases, mental health, birth outcomes, sexual and reproductive health, physical and developmental health, parasitic infections, oral health, respiratory health, preventative health, endocrine disorders, health care services, and haematological conditions. The findings offer insights into factors influencing the health of African immigrant and refugee children. Further studies, especially qualitative studies, are needed to determine barriers to service access after migration and to investigate other underexplored and overlooked health concerns of African migrant children, including pneumonia and child maltreatment.
Collapse
Affiliation(s)
- Bukola Salami
- Faculty of Nursing, University of Alberta, 11405 87 Avenue, Edmonton, AB T6G 0Z7, Canada; (H.F.-S.); (M.T.); (A.B.); (S.R.)
| | - Higinio Fernandez-Sanchez
- Faculty of Nursing, University of Alberta, 11405 87 Avenue, Edmonton, AB T6G 0Z7, Canada; (H.F.-S.); (M.T.); (A.B.); (S.R.)
| | - Christa Fouche
- Faculty of Education and Social Work, University of Auckland, Private Bag 92019, Auckland 1142, New Zealand;
| | - Catrin Evans
- School of Health Sciences, University of Nottingham, University Park, Nottingham NG7 2RD, UK;
| | - Lindiwe Sibeko
- Department of Nutrition, School of Public Health and Health Sciences, University of Massachusetts, 204 Chenoweth Laboratory, Amherst, MA 01003-9282, USA;
| | - Mia Tulli
- Faculty of Nursing, University of Alberta, 11405 87 Avenue, Edmonton, AB T6G 0Z7, Canada; (H.F.-S.); (M.T.); (A.B.); (S.R.)
| | - Ashley Bulaong
- Faculty of Nursing, University of Alberta, 11405 87 Avenue, Edmonton, AB T6G 0Z7, Canada; (H.F.-S.); (M.T.); (A.B.); (S.R.)
| | - Stephen Owusu Kwankye
- Regional Institute for Population Studies, University of Ghana, P.O. Box LG 96, Legon, Accra GA184, Ghana;
| | - Mary Ani-Amponsah
- School of Nursing, University of Ghana, P.O. Box LG 43, Legon, Accra GA184, Ghana;
| | | | - Hayat Gommaa
- Department of Nursing Science, Ahmadu Bello University, Sokoto Road, PMB 06, Zaria 810107, Nigeria;
| | - Kafuli Agbemenu
- School of Nursing, The State University of New York (SUNY), University at Buffalo, 3435 Main Street, Buffalo, NY 14214, USA;
| | | | - Solina Richter
- Faculty of Nursing, University of Alberta, 11405 87 Avenue, Edmonton, AB T6G 0Z7, Canada; (H.F.-S.); (M.T.); (A.B.); (S.R.)
| |
Collapse
|
4
|
Intestinal parasites may be associated with later behavioral problems in internationally adopted children. PLoS One 2021; 16:e0245786. [PMID: 33493225 PMCID: PMC7833226 DOI: 10.1371/journal.pone.0245786] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Accepted: 12/29/2020] [Indexed: 01/09/2023] Open
Abstract
Aim At arrival in new home country, internationally adopted children often have intestinal parasites. International adoptees also exhibit more behavioral problems than their biological peers. We examined whether intestinal parasite infections in international adoptees on arrival in Finland are associated with their later behavioral and emotional problems. Methods Data for this study were sourced from the Finnish Adoption Study (FinAdo) based on parental questionnaires for all internationally adopted children under 18 years (n = 1450) who arrived in Finland from 1985 to 2007. A total of 1293 families provided sufficient information on the adoptee’s background, parasitic status on arrival, and behavioral symptoms at the median time of 5 years after arrival (mean age = 7.8 years). Behavioral and emotional disorders were evaluated with the Child Behavior Checklist (CBCL). Statistical analyses were conducted using linear regression. Results Of the 1293 families, parents of 206 adoptive children reported intestinal parasites in their adopted children on arrival. Parasite-infected children had subsequently higher CBCL problem scores than the children without parasites (p < 0.001). The association between intestinal parasites and later behavioral problems was stronger than that between intestinal parasites and any other factors measured in this study, except disability. Limitations The control group was naturally provided by the adopted children without parasite infections, but we could not compare the adopted children to non-adopted children without a defined parasite infection. We were unable to specify the effects associated with a specific parasite type. It was not possible either to include multiple environmental factors that could have been associated with behavioral problems in the models, which indicated only modest explanatory values. Conclusions In this study, intestinal parasite infections in early childhood may be associated with children’s later psychological wellbeing, even in children who move to a country with a low prevalence of parasites. Our findings may support further developments pertaining to the gut-brain theory.
Collapse
|
5
|
Discrepancies between Vaccine Documentation and Serologic Status for Diphtheria, Tetanus, and Hepatitis B in Internationally Adopted Children. Vaccines (Basel) 2020; 8:vaccines8030489. [PMID: 32872676 PMCID: PMC7563378 DOI: 10.3390/vaccines8030489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 08/25/2020] [Accepted: 08/27/2020] [Indexed: 12/04/2022] Open
Abstract
Internationally Adopted Children (IAC) often show suboptimal immunisation coverage, but available data are discordant. Data at the first evaluation of 2073 IAC (median age: 6 years) referred to the Meyer Children’s University Hospital (Florence, Italy) in 2009–2019 were analysed in order to evaluate their immunisation status against diphtheria, tetanus, and hepatitis B. Negative antibody titres were observed in 11.5% of the IAC for diphtheria, 18.6% for tetanus, and 39.0% for hepatitis B. At multivariate analysis, originating from Africa was an independent risk factor for seronegativity for the three diseases (p < 0.001), while age below four years was an independent factor associated with protective immunity, only considering hepatitis B (p < 0.001). Vaccine documentation was an additional factor independently associated with protective immunity. However, a discrepancy between documentation (indicating previous vaccinations) and serology (showing negative antibody titres) was evidenced in 3.8% of the children for diphtheria, 12.6% for tetanus, and 29.6% for hepatitis B. This finding suggests that although vaccine documentation may reflect the presence of protective antibody titres, it should not be accepted as absolute evidence of protective immunity, underlining the importance of a complete assessment of immunisation status in IAC, particularly in those originating from Africa and aged over four years.
Collapse
|
6
|
Assessment of the Clinical and Economic Impact of Different Immunization Protocols of Measles, Mumps, Rubella and Varicella in Internationally Adopted Children. Vaccines (Basel) 2020; 8:vaccines8010060. [PMID: 32024209 PMCID: PMC7157696 DOI: 10.3390/vaccines8010060] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Revised: 01/28/2020] [Accepted: 01/30/2020] [Indexed: 12/11/2022] Open
Abstract
The appropriate immunization of internationally adopted children (IAC) is currently under debate and different approaches have been suggested. The aim of this study is to evaluate the clinical and economic impact of different strategies of measles, mumps, rubella, and varicella (MMRV) immunization in IAC in Italy. A decision analysis model was developed to compare three strategies: presumptive immunization, pre-vaccination serotesting and vaccination based on documentation of previous immunization. Main outcomes were the cost of strategy, number of protected IAC, and cost per child protected against MMRV. Moreover, the incremental cost-effectiveness ratio (ICER) was calculated. The strategy currently recommended in Italy (immunize based on documentation) is less expensive. On the other hand, the pre-vaccination serotesting strategy against MMRV together, improves outcomes with a minimum cost increase, compared with the presumptive immunization strategy and compared with the comparator strategy. From a cost-effectiveness point of view, vaccination based on serotesting results in being the most advantageous strategy compared to presumptive vaccination. By applying a chemiluminescent immunoassay test, the serology strategy resulted to be clinically and economically advantageous. Similar results were obtained excluding children aged <1 year for both serology methods. In conclusion, based on our analyses, considering MMRV vaccine, serotesting strategy appears to be the preferred option in IAC.
Collapse
|
7
|
Immunization Status against Measles, Mumps, Rubella and Varicella in a Large Population of Internationally Adopted Children Referred to Meyer Children's University Hospital from 2009 to 2018. Vaccines (Basel) 2020; 8:vaccines8010051. [PMID: 32013010 PMCID: PMC7158658 DOI: 10.3390/vaccines8010051] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2019] [Revised: 01/24/2020] [Accepted: 01/25/2020] [Indexed: 02/07/2023] Open
Abstract
Control of vaccine preventable diseases (VPDs) is a challenge for healthcare systems. Different studies highlighted the suboptimal immunization of internationally adopted children (IAC). To evaluate the immunization status against measles, mumps, rubella (MMR), and varicella (V) in a large cohort of IAC, data at first screening visit of all IAC (<18 years) consecutively referred to Meyer Children's University Hospital (Florence, Italy) from 2009 to 2018 were collected and analyzed. In total, 1927 children (median age: 5.99 years, interquartile range: 3.33-8.21) were enrolled. More than half of IAC were unprotected against MMR-V. The reliability of the vaccination documentation of the country of origin was poor, since more than a quarter of the IAC serologically tested were not protected against MMR-V, despite the vaccination documentation attesting previous vaccination. This was significantly more pronounced in children aged 15-18 years and in those originating from Africa. High rate of discordant serological results/documentation brings up questions regarding the optimal management of IACs, and suggests a rapid, careful, and complete assessment of immunization status timely after IAC's arrival. Serological testing of IAC of all ages followed by vaccination of seronegative children should be provided.
Collapse
|
8
|
de Martino M, Galli L, Chiappini E. The internationally adopted child: overview of challenging issues. Acta Paediatr 2019; 108:396-397. [PMID: 30152882 DOI: 10.1111/apa.14425] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Maurizio de Martino
- Department of Health Sciences, Meyer's Children's University Hospital, University of Florence, Florence, Italy
| | - Luisa Galli
- Department of Health Sciences, Meyer's Children's University Hospital, University of Florence, Florence, Italy
| | - Elena Chiappini
- Department of Health Sciences, Meyer's Children's University Hospital, University of Florence, Florence, Italy
| |
Collapse
|
9
|
Venturini E, Piccini P, Tersigni C, Chiappini E, Galli L. Systematic review shows that immunising internationally adopted children is a major challenge for primary health care. Acta Paediatr 2019; 108:411-418. [PMID: 30368909 DOI: 10.1111/apa.14625] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2018] [Revised: 08/30/2018] [Accepted: 10/23/2018] [Indexed: 11/30/2022]
Abstract
AIM This systematic review aimed to provide an overview of the immunisation of internationally adopted children and to discuss possible vaccination strategies. METHODS A literature search was performed covering papers published in English from 1988 to 15 June 2018 using the Ovid MEDLINE, EMBASE and Cochrane Library databases. This identified 749 studies and 41 full texts were evaluated. RESULTS Overall, 19 studies conducted between 1988 and 2016 fulfilled our inclusion criteria. These covered 7663 children aged 1.1-5.7 years adopted from Asia, Eastern Europe, Africa and South and Central America. Tetanus protective antibody levels ranged from 35 to 95%, and similar data were reported for diphtheria. A higher percentage of adoptees had protective antibody levels for polio (50-93%) and measles (62-95%). More than a third (35%) did not have protective antibody titres for hepatitis B. Only one study investigated adoptees with protective antibodies against haemophilus influenza, and it reported that this was around 66%. CONCLUSION The appropriate immunisation of internationally adopted children is a major challenge for primary health care and a number of different approaches have been suggested, with no clear conclusions. Further studies on the cost-effectiveness of different approaches should be performed to optimise screening strategies and develop recommendations.
Collapse
Affiliation(s)
- Elisabetta Venturini
- Department of Health Sciences University of Florence Anna Meyer Children's University Hospital Florence Italy
| | - Paola Piccini
- Department of Health Sciences University of Florence Anna Meyer Children's University Hospital Florence Italy
| | - Chiara Tersigni
- Department of Health Sciences University of Florence Anna Meyer Children's University Hospital Florence Italy
| | - Elena Chiappini
- Department of Health Sciences University of Florence Anna Meyer Children's University Hospital Florence Italy
| | - Luisa Galli
- Department of Health Sciences University of Florence Anna Meyer Children's University Hospital Florence Italy
| |
Collapse
|
10
|
Meier NR, Volken T, Geiger M, Heininger U, Tebruegge M, Ritz N. Risk Factors for Indeterminate Interferon-Gamma Release Assay for the Diagnosis of Tuberculosis in Children-A Systematic Review and Meta-Analysis. Front Pediatr 2019; 7:208. [PMID: 31192175 PMCID: PMC6548884 DOI: 10.3389/fped.2019.00208] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2018] [Accepted: 05/08/2019] [Indexed: 12/26/2022] Open
Abstract
Background: Interferon-gamma release assays (IGRA) are well-established immunodiagnostic tests for tuberculosis (TB) in adults. In children these tests are associated with higher rates of false-negative and indeterminate results. Age is presumed to be one factor influencing cytokine release and therefore test performance. The aim of this study was to systematically review factors associated with indeterminate IGRA results in pediatric patients. Methods: Systematic literature review guided by the preferred reporting items for systematic reviews and meta-analyses (PRISMA) searching PubMed, EMBASE, and Web of Science. Studies reporting results of at least one commercially available IGRA (QuantiFERON-TB, T-SPOT.TB) in pediatric patient groups were included. Random effects meta-analysis was used to assess proportions of indeterminate IGRA results. Heterogeneity was assessed using the I2 value. Risk differences were calculated for studies comparing QuantiFERON-TB and T-SPOT.TB in the same study. Meta-regression was used to further explore the influence of study level variables on heterogeneity. Results: Of 1,293 articles screened, 133 studies were included in the final analysis. These assessed QuantiFERON-TB only in 77.4% (103/133), QuantiFERON-TB and T-SPOT.TB in 15.8% (21/133), and T-SPOT.TB only in 6.8% (9/133) resulting in 155 datasets including 107,418 participants. Overall 4% of IGRA results were indeterminate, and T-SPOT.TB (0.03, 95% CI 0.02-0.05) and QuantiFERON-TB assays (0.05, 95% CI 0.04-0.06) showed similar proportions of indeterminate results; pooled risk difference was-0.01 (95% CI -0.03 to 0.00). Significant differences with lower proportions of indeterminate assays with T-SPOT.TB compared to QuantiFERON-TB were only seen in subgroup analyses of studies performed in Africa and in non-HIV-infected immunocompromised patients. Meta-regression confirmed lower proportions of indeterminate results for T-SPOT.TB compared to QuantiFERON-TB only among studies that reported results from non-HIV-infected immunocompromised patients (p < 0.001). Conclusion: On average indeterminate IGRA results occur in 1 in 25 tests performed. Overall, there was no difference in the proportion of indeterminate results between both commercial assays. However, our findings suggest that in patients in Africa and/or patients with immunocompromising conditions other than HIV infection the T-SPOT.TB assay appears to produce fewer indeterminate results.
Collapse
Affiliation(s)
- Noëmi R Meier
- Mycobacterial Research Laboratory, University of Basel Children's Hospital, Basel, Switzerland.,Faculty of Medicine, University of Basel, Basel, Switzerland
| | - Thomas Volken
- School of Health Professions, Zürich University of Applied Sciences, Winterthur, Switzerland
| | - Marc Geiger
- Faculty of Medicine, University of Basel, Basel, Switzerland
| | - Ulrich Heininger
- Faculty of Medicine, University of Basel, Basel, Switzerland.,Paediatric Infectious Diseases and Vaccinology Unit, University of Basel Children's Hospital, Basel, Switzerland
| | - Marc Tebruegge
- UCL Great Ormond Street Institute of Child Health, University College London, London, United Kingdom.,Department of Paediatric Infectious Diseases and Immunology, Evelina London Children's Hospital, Guy's and St. Thomas' NHS Foundation Trust, London, United Kingdom.,Royal Children's Hospital Melbourne, Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia
| | - Nicole Ritz
- Mycobacterial Research Laboratory, University of Basel Children's Hospital, Basel, Switzerland.,Faculty of Medicine, University of Basel, Basel, Switzerland.,Paediatric Infectious Diseases and Vaccinology Unit, University of Basel Children's Hospital, Basel, Switzerland.,Royal Children's Hospital Melbourne, Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia
| |
Collapse
|
11
|
|