Objective Interferon gamma release assays (IGRA) have recently been introduced into clinical practice for the diagnosis of tuberculosis (TB). Current UK guidelines recommend the use of IGRA to aid the diagnosis of latent TB. We aimed to survey paediatric TB specialists on their use of IGRA.
Methods TB specialists were identified by a method described previously (Adalat et al) and sent the six-question survey by e-mail between January and February 2008.
Results 39/100 paediatricians completed the survey. 60% had used IGRA. Practice varied in the use of the tests in specified patient groups. IGRA were used outside the indications of the national guidelines by 22 paediatricians. 16% had IGRA performed in their local laboratory, 22% sent specimens >100 miles away. Only 9% reported no pragmatic problems with IGRA use. Laboratory accessibility, costs, and sceptism about the clinical value of the tests were reported to preclude the use of these assays in the investigation of TB.
Conclusions IGRA are not readily available for use throughout the UK. When available, there are variations amongst paediatricians in the clinical applications; national guidelines are not adhered to. Uncertainty about the clinical value of these tests also precludes their use. Longitudinal studies of IGRA in children with latent TB are needed. If these show benefit and cost effectiveness, then availability and funding for these tests will need to be reviewed.