Interferon-gamma release assays versus tuberculin skin test for latent tuberculosis infection positivity among healthcare workers and first responders: a systematic review and meta-analysis
International Journal of Infectious Diseases·
- DOI
- 10.1016/j.ijid.2026.108949
- PMID
- 42398701
- PMCID
- —
- OpenAlex
- W7167226752
- Study type
- Systematic review
- Publisher
- Elsevier BV
- Article type
- journal-article
- Integrity
- current
Why this research matters now
Latent tuberculosis infection remains common among healthcare workers, and positivity estimates vary substantially by diagnostic method. The association of TST positivity with BCG vaccination suggests IGRA may offer greater specificity for screening BCG-vaccinated occupational groups.
Structured evidence summary
Research question
The study estimates latent tuberculosis infection positivity among hospital healthcare workers and first responders, comparing interferon-gamma release assays and tuberculin skin tests.
Study design
Systematic review and meta-analysis of observational studies published from 2000 onward, with pooled proportions estimated using Freeman-Tukey double arcsine transformation and random-effects meta-regression.
Population and setting
Hospital healthcare workers and first responders across 41 countries, totaling 63,988 participants from 95 included studies; estimates were stratified by World Health Organization TB incidence region.
Main findings
Pooled IGRA positivity was 22% (95% CI: 17-28%) and pooled TST positivity was 38% (95% CI: 31-44%). Among studies reporting both tests, pooled positivity was 46% lower with IGRA than TST. TST positivity, but not IGRA positivity, was significantly associated with higher BCG vaccination rates.
Public-health relevance
Latent tuberculosis infection remains common among healthcare workers, and positivity estimates vary substantially by diagnostic method. The association of TST positivity with BCG vaccination suggests IGRA may offer greater specificity for screening BCG-vaccinated occupational groups.
Important limitations
No explicit limitations are stated in the supplied abstract. The summary is limited to the supplied single-article abstract and bibliographic metadata and requires the original paper for decision-grade interpretation.
GIDS interpretation
The article is discoverable through topical classifiers for Diagnostics, Vaccination, and Tuberculosis, which may assist contextual indexing of LTBI screening literature for occupational health audiences.
Related GIDS surveillance
Literature context does not validate, explain, or change a surveillance signal. Exact and contextual relationships are shown separately.
Evidence relationships
This article has 8 auditable classifier relationships to diseases, places, topics, and study design.