Acceptability of interferon-gamma release assays among healthcare workers who receive routine employee tuberculosis testing

Abstract

Background: Healthcare workers (HCWs) undergo annual testing for latent tuberculosis infection (LTBI).

Objective: Compare acceptability of tuberculin skin test (TST) and interferon-gamma release assay (IGRA) among HCWs.

Methods: HCWs at four medical centers in the US were administered an acceptability questionnaire including a brief objective description of both tests and eliciting attitudes regarding TST and IGRAs, confidence in results, and likelihood of taking LTBI treatment.

Results: Of 406 participants, 75% had never heard of IGRAs. IGRAs were preferred to TST. Belief in accuracy of hypothetical positive results of TST or IGRA and willingness to accept LTBI treatment were similar across tests. When presented with hypothetical discordant results, HCWs expressed more confidence in IGRAs. Perceived accuracy of results was the most important factor in test preferences.

Conclusions: Although HCWs preferred and indicated more confidence in IGRAs, the likelihood that HCWs would believe LTBI diagnosis and initiate treatment based on positive results was similar for TST and IGRAs.

Keywords:

• Healthcare worker TB screening
• Interferon-gamma release assays
• QuantiFERON
• T-Spot
• TB testing
• Tuberculosis

Financial support: This study was supported by contracts from the CDC TBESC to the study sites.

Conflict of interest: All authors report no conflicts of interest relevant to this article.

The authors thank the study participants, whose time and interest made this study possible. The authors gratefully acknowledge the contributions and dedication of the following study team members who implemented study procedures:

Denver, Colorado: Robert Belknap, Amy Graepler, Michael Higgins, Kristian Keane, Juanita Lovato, Matt Parker, Timothy Perdue, Alessandra Mills, Marie Rainey, Randall Reves, Kirsten Wall, Michael Wilson.

Baltimore, Maryland: Sandra Chon, Susanna Collins, Wendy Cronin, Susan E. Dorman, Anup Kesavan, Gina Maltas, Elizabeth Munk, Richard Oatis, Heather Rutz, Katherine Taylor, Yaping Wang.

Houston, Texas: Marilou Cook, C. Ray Daulton, Jacqueline A. Deville, Marsha L. Feske, Edward A. Graviss, Ngan Ha, Sopheap Im, James E. Kelaher, Justin D. Lew, Mayuri Palmer, Larry D. Teeter.

New York, New York: Daniel Brodie, Yael Hirsch-Moverman, Heejin Kim, Yukey Lei, Neil Schluger, Joyce Ann Moran, Simon Tsiouris, George Zhang.

CDC, Atlanta, Georgia: Denise Garrett, Gerald Mazurek.

Westat, Inc.: Paul Weinfurter.

Disclosure: Role of sponsor: The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.