Title
Lessons Learned from Implementation of an Interferon Gamma Release Assay to Screen for Latent Tuberculosis Infection in a Large Multicenter Observational Cohort Study in Brazil
Date Issued
2021
Access level
open access
Resource Type
journal article
Author(s)
Costa A.G.
Carvalho B.K.S.
Araújo-Pereira M.
Ibiapina H.N.S.
Spener-Gomes R.
Souza A.B.
Gomes-Silva A.
Andrade A.M.S.
Silva E.C.
Benjamin A.
Rocha M.S.
Moreira A.S.R.
Oliveira J.G.
Figueiredo M.C.
Turner M.M.
Durovni B.
Cavalcante S.
Kritski A.L.
Rolla V.C.
Sterling T.R.
Andrade B.B.
Cordeiro-Santos M.
Instituto Gonçalo Moniz
Publisher(s)
American Society for Microbiology
Abstract
The interferon gamma release assay (IGRA) has emerged as a useful tool for identifying latent tuberculosis infection (LTBI). This assay can be performed through testing platforms such as the QuantiFERON-TB Gold Plus (QFT-Plus) assay. This in vitro test has been incorporated into several guidelines worldwide and has recently been considered by the World Health Organization (WHO) for the diagnosis of LTBI. The possibility of systematically implementing IGRAs such as the QFT-Plus assay in centers that perform LTBI screening has been accelerated by the decreased availability of the tuberculin skin test (TST) in several countries. Nevertheless, the process to implement IGRA testing in routine clinical care has many gaps. The study utilized the expertise acquired by the laboratory teams of the Regional Prospective Observational Research in Tuberculosis (RePORT)-Brazil consortium during study protocol implementation of LTBI screening of tuberculosis (TB) close contacts. RePORT-Brazil includes clinical research sites from Brazilian cities and is the largest multicenter cohort of TB close contacts in the country to date. Operational and logistical challenges faced during IGRA implementation in all study laboratories are described, as well as the solutions that were developed and led to the successful establishment of IGRA testing in RePORT-Brazil. The descriptions of the problems identified and resolved in this study can assist laboratories implementing IGRAs, in addition to manufacturers of IGRAs providing effective technical support. This will facilitate the implementation of IGRA testing in countries with large TB burdens, such as Brazil. IMPORTANCE The IGRA has emerged as a useful tool for identifying persons with LTBI. Although the implementation of IGRAs is of utmost importance, to our knowledge there is scarce information on the identification of logistical and technical challenges for systematic screening for LTBI on a large scale. Thus, the descriptions of the problems identified and resolved in this study can assist laboratories implementing IGRAs, in addition to manufacturers of IGRAs providing effective technical support. This will facilitate the implementation of IGRA testing in countries with large TB burdens, such as Brazil.
Volume
9
Issue
3
Language
English
OCDE Knowledge area
Sistema respiratorio Enfermedades infecciosas
Scopus EID
2-s2.0-85122810045
PubMed ID
Source
Microbiology Spectrum
ISSN of the container
21650497
Sponsor(s)
The RePORT-Brazil Consortium consists of 12 partner institutions from Brazil repre-sented by the following members: Amanda Araújo da Costa, Instituto de Pesquisa Clínica Carlos Borborema, Fundação de Medicina Tropical Doutor Heitor Vieira Dourado, Manaus, Brazil; André Luiz Bezerra, Faculdade de Medicina, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil; Anna Cristina Calçada Carvalho, Faculdade de Medicina, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil, and Laboratório de Inovações em Terapias, Ensino e Bioprodutos, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil; Anna Karla Silveira, Faculdade de Medicina, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil; Betânia M. F. Nogueira, IBIT, Fundação José Silveira, Salvador, Brazil, Multinational Organization Network Sponsoring Translational and Epidemiological Research (MONSTER) Initiative, Salvador, Brazil, and Faculdade de Medicina, Universidade Federal da Bahia, Salvador, Brazil; Bruna da Costa Oliveira Lima, Instituto de Pesquisa Clínica Carlos Borborema, Fundação de Medicina Tropical Doutor Heitor Vieira Dourado, Manaus, Brazil; Bruna Pires de Loiola, Instituto de Pesquisa Clínica Carlos Borborema, Fundação de Medicina Tropical Doutor Heitor Vieira Dourado, Manaus, Brazil; Carolina Arana Schmaltz Stanis, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil; Eline Naiane de Freitas Medeiros, Instituto de Pesquisa Clínica Carlos Borborema, Fundação de Medicina Tropical Doutor Heitor Vieira Dourado, Manaus, Brazil; Francine Peixoto Ignácio, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil; Hayna Malta Santos, Faculdade de Medicina, Universidade Federal da Bahia, Salvador, Brazil, and Laboratório de Inflamação e Biomarcadores, Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, Brazil; Jéssica Rebouças Silva, Faculdade de Medicina, Universidade Federal da Bahia, Salvador, Brazil, and Laboratório de Inflamação e Biomarcadores, Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, Brazil; João Marine Neto, SMS-RJ, Rio de Janeiro, Brazil, and Hospital Federal do Andaraí, Ministério da Saúde, Brazil; Leandro Sousa Garcia, Instituto de Pesquisa Clínica Carlos Borborema, Fundação de Medicina Tropical Doutor Heitor Vieira Dourado, Manaus, Brazil; Maria Luciana Silva-Freitas, Laboratório Interdisciplinar de Pesquisas Médicas, Instituto Oswaldo Cruz, FIOCRUZ, Rio de Janeiro, Brazil; Mayla Gabriele Miranda de Melo, Faculdade de Medicina, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil; Rosa Maria Placido-Pereira, Laboratório Interdisciplinar de Pesquisas Médicas, Instituto Oswaldo Cruz, FIOCRUZ, Rio de Janeiro, Brazil; Samyra Almeida-Da-Silveira, Laboratório Interdisciplinar de Pesquisas Médicas, Instituto Oswaldo Cruz, FIOCRUZ, Rio de Janeiro, Brazil; Vanessa de Souza Nascimento, IBIT, Fundação José Silveira, Salvador, Brazil, MONSTER Initiative, Salvador, Brazil, and Bahiana School of Medicine and Public Health, Bahia Foundation for the Development of Sciences, Salvador, Brazil. The study was supported by the Intramural Research Program of the Fundação Oswaldo Cruz (B.B.A.), the Intramural Research Program of the Fundação José Silveira (B.B.A. and M.S.R.), Departamento de Ciência e Tecnologia (DECIT), Secretaria de Ciência e Tecnologia (SCTIE), Ministério da Saúde, Brazil (grant 25029.000507/2013-07 to V.C.R.), and the National Institute of Allergy and Infectious Diseases (grant U01-AI069923 to T.R.S., A.B.S., M.C.F., M.S.R., A.B., A.S.R.M., J.G.O., V.C.R., B.D., A.L.K., S.C., T.R.S., B.B.A., and M.C.S). M.A.-P. received a fellowship from Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (finance code 001). M.B.A. received a research fellowship from the Fundação de Amparo à Pesquisa do Estado da Bahia (FAPESB). A.L.K., V.C.R., and B.B.A. are senior investigators, whereas A.B.S. is a PhD fellow from the Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq), Brazil.
Sources of information: Directorio de Producción Científica Scopus