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Studies have shown that QFT is more accurate than the TST as it is notaffected by BCG vaccination exposure to non-tuberculous mycobacteria. Greateraccuracy means universities have to spend less money and time during thescreening process. It streamlines the admission process and provides easiertest administration for both universities and students as only one medicalconsultation is required; results are objective and can be available within 24hours. Most importantly, treatment is dispensed to individuals truly infectedwith TB.
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Each year US universities/colleges host approximately 500,000international students. Many of these students come from high TB incidenceareas within Asia, Africa, Eastern Europe and Central and South America. TheACHA guidelines build on those issued by the Centers for Disease Control andPrevention (CDC) which state that QFT "can be used in all circumstances inwhich the TST is currently used" The ACHA recommends screening all incomingstudents, but particularly targeting those at increased risk for TB, whichincludes students from countries with a high incidence of TB disease (greaterthan or equal to 20 cases / 100,000 population). These students should betested for latent TB infection (with either QFT or the TST), to reduce therisk of developing active TB disease. Additionally the ACHA guidelinesrecommend that health profession students, whether incoming or continuing,should be tested annually.
QFT is being used by a growing number of US colleges and universitiesincluding the University of Tennessee Health Science Center which publishedthe first report of a college TB control program utilizing QFT (Vesser et al2007). The report showed that QFT can be successfully implemented and is wellaccepted as an addition to a campus-wide TB surveillance program.
References
ACHA Guidelines-Tuberculosis Screening and Targeted Testing of College andUniversity Students.
http://www.acha.org/Info_resources/tb_statement.pdf
Centers for Disease Control MMWR Dec 16 2005, Vol. 54, No. RR-15. VeeserPI, Smith PK, Handy B, Martin SR.
Tuberculosis screening on a health science campus: use of QuantiFERON-TBGold test for students and employees. J Am Coll Health 2007; 56:175-80.
About QuantiFERON(R)-TB Gold (QFT(TM)):
QFT -- a simple blood test -- is the first major advance in TB diagnosissince the introduction of the tuberculin skin test (TST) over 100 years ago.The QFT test is based on measurement of a cell-mediated immune response in TB-infected individuals. The T-cells of these individuals are sensitized to TB,and respond to stimulation with peptides simulating those expressed by the TBcausing bacteria, secreting a cytokine called interferon-gamma. QFT accuratelymeasures the interferon-gamma response in a sensitive enzyme assay. QFT isunaffected by previous BCG vaccination and most other mycobacteria. Unlike theTST, it requires only one patient visit, is a controlled laboratory test, andprovides an objective, reproducible result that is
