| Objective:To analyze the diagnostic utility of Enzyme-linked immunospot assay (ELISPOT) in children with tuberculosis in XinJiang area. Method:Total of 115 consecutive cases of children aged from 0~14 years who were being assessed for suspected tuberculosis were enrolled in this study .All of them received ELISPOT and full clinical assessment, part of them received PPD test, the final diagnoses were assessed through 3~6month follow-up. The ELISPOT results were compared with the final diagnoses to calculate the diagnostic parameters (sensitivity, specificity, agreement, likelihood ratio , predictive value, et al ), and were compared with those of PPD test. Result:In The sensitivity of ELISPOT was 80% , specificity was 86%,.agreement was 83% .The positive likelihood ratio, negative likelihood ratio, positive predictive value and negative predictive value of ELISPOT were 5.865, 0.232, 87%, 79% respectively. Compared with PPD test, the sensitivity of ELISPOT (80%) was significantly higher than that of PPD test (43%) (P<0.01), the specificity of ELISPOT (86%) and that of PPD test (88%) had no statistical difference (P>0.05). In tuberculosis group, the positive rates of PPD test fell significantly in children with malnutrition or with severe tuberculosis (tuberculous meningitis or acute miliary tuberculosis) (P<0.05), while that of ELISPOT had no significant differences in those subgroups(P>0.05). In the subgroups of≤36 month and >36 month, Uygurs and Han, pulmonary tuberculosis and extrapulmonary tuberculosis, the positive rates of both ELISPOT and PPD test had no significant differences(P<0.05). An improved sensitivity (90%) can be acquired when these two tests were combined. Conclusion:ELISPOT is sensitive and fast to diagnose childhood tuberculosis and is less affected by factors such as malnutrition and severe tuberculosis. Owing to having better diagnostic value, ELISPOT can be applied in the early diagnosis of childhood tuberculosis in Xinjiang area.
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