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Alavi-Naini R, Sargolzaie N, Metanat M. Relationship between Tuberculin Skin Test and COVID-19 Outcomes among Patients with COVID-19 in Zahedan, Iran. Tanaffos 2022; 21:154-160. [PMID: 36879735 PMCID: PMC9985127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Accepted: 10/17/2021] [Indexed: 03/08/2023]
Abstract
Background Ecological studies showed that countries with national Bacillus Calmette-Guerin (BCG) vaccination programs for tuberculosis prevention reported lower incidences of severe and fatal COVID-19 than countries without such programs. Several studies have demonstrated that the BCG vaccine can induce long-term trained Immunity in bone marrow progenitor cells. In this study, we tried to evaluate the relationship between tuberculin skin test results, BCG scar, and COVID-19 outcomes among patients with confirmed COVID-19. Materials and Methods This was a cross-sectional study. Cases included 160 patients with confirmed COVID-19 in Zahedan hospitals (southeast Iran) in 2020, selected by convenient sampling. PPD test was performed for all patients through the intradermal technique. Collected data included demographic information, underlying conditions, PPD test results, and COVID-19 outcome. Analysis was conducted utilizing ANOVA, χ2 test, and multivariate analysis (logistic regression). Results The univariate analysis showed a positive relationship between older age, having underlying diseases, and positive tuberculin skin test results with the outcome of COVID-19. We also found a lower frequency of BCG scar among patients with death outcomes than recovered ones. In the multivariate analysis by logistic regression through the backward method, only age and underlying diseases remained predictors of death. Conclusion Tuberculin test results might be dependent on age and underlying conditions. Our study did not show relationship between BCG vaccine and mortality in COVID-19 patients. Further investigations in different settings are required to reveal the efficacy of the BCG vaccine in preventing this devastating disease.
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Affiliation(s)
- Roya Alavi-Naini
- Infectious Diseases and Tropical Medicine Research Center, Resistant Tuberculosis Institute, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Narjes Sargolzaie
- Infectious Diseases and Tropical Medicine Research Center, Resistant Tuberculosis Institute, Zahedan University of Medical Sciences, Zahedan, Iran.,Clinical Immunology Research Center, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Maliheh Metanat
- Infectious Diseases and Tropical Medicine Research Center, Resistant Tuberculosis Institute, Zahedan University of Medical Sciences, Zahedan, Iran
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Sousa S, Rocha D, Silva JC, Ribeiro AI, Gonçalves G, Almeida Á, Correia AM, Duarte R, Carvalho C. Comparing the cost-effectiveness of two screening strategies for latent tuberculosis infection in Portugal. Pulmonology 2021; 27:493-499. [PMID: 34053903 DOI: 10.1016/j.pulmoe.2021.04.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2020] [Revised: 04/07/2021] [Accepted: 04/08/2021] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION AND OBJECTIVES Screening for latent tuberculosis infection (LTBI) in close contacts of infectious TB cases might include Tuberculin Skin Test (TST) and Interferon-Gamma Release Assays (IGRA), in combination or as single-tests. In Portugal, the screening strategy changed from TST followed by IGRA to IGRA-only testing in 2016. Our objective was to compare the cost-effectiveness of two-step TST/IGRA with the current IGRA-only screening strategy in immunocompetent individuals exposed to individuals with respiratory TB. MATERIALS AND METHODS We reviewed clinical records of individuals exposed to infectious TB cases diagnosed in 2015 and 2016, in two TB outpatient centers in the district of Porto. We estimated medical, non-medical and indirect costs for each screening strategy, taking into account costs of tests and health care personnel, travel distance from place of residence to screening site and employment status. We calculated the incremental cost-effectiveness ratio (ICER) as the cost difference between the two screening strategies with the difference number of LTBI diagnosis as a measure of cost-effectiveness, assuming that treating LTBI is a cost-effective intervention. We also calculated adjusted odds-ratios to test the association between diagnosis of LTBI and screening strategy and estimated the total cost for averting a potential TB case. RESULTS We compared 499 contacts TST/IGRA screened with 547 IGRA-only. IGRA-only strategy yielded a higher screening effectiveness for diagnosing latent tuberculosis infection (aOR 2.12, 95%CI: 1.53 - 2.94). ICER was €106 per LTBI diagnosis, representing increased effectiveness with a slightly increased cost of IGRA-only screening strategy. CONCLUSIONS Our data suggests that in Portugal LTBI screening with IGRA-only is more cost-effective than the two-step TST/IGRA testing strategy, preventing a higher number of cases of TB cases.
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Affiliation(s)
- Sofia Sousa
- Public Health Unit - South Sousa Valley, Northern Regional Health Administration, Paredes, Portugal; Multidisciplinary Unit for Biomedical Research (UMIB), Institute of Biomedical Sciences Abel Salazar, University of Porto, Porto, Portugal.
| | - Diogo Rocha
- Faculty of Medicine, University of Porto, Porto, Portugal
| | - Joelma C Silva
- Pulmonology Department of Centro Hospitalar de Trás-os-Montes e Alto Douro, Vila Real, Portugal
| | - Ana Isabel Ribeiro
- Epidemiology Research Unit (EpiUnit) - Institute of Public Health, University of Porto, Porto, Portugal; Departamento de Ciências de Saúde Pública, Ciências Forenses e Educação Médica, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Guilherme Gonçalves
- Multidisciplinary Unit for Biomedical Research (UMIB), Institute of Biomedical Sciences Abel Salazar, University of Porto, Porto, Portugal
| | - Álvaro Almeida
- CEF.UP - Center for Economics and Finance at the University of Porto and Faculdade de Economia, Universidade do Porto
| | - Ana Maria Correia
- Northern Regional Health Administration, Department of Public Health, Porto, Portugal
| | - Raquel Duarte
- Epidemiology Research Unit (EpiUnit) - Institute of Public Health, University of Porto, Porto, Portugal; Departamento de Ciências de Saúde Pública, Ciências Forenses e Educação Médica, Faculty of Medicine, University of Porto, Porto, Portugal; Serviço de Pneumologia, Centro Hospitalar de Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal; National Tuberculosis Program, Directorate-General of Health, Lisbon, Portugal
| | - Carlos Carvalho
- Public Health Unit - South Sousa Valley, Northern Regional Health Administration, Paredes, Portugal; Department of Public Health, Northern Regional Health Administration, Porto, Portugal; Multidisciplinary Unit for Biomedical Research (UMIB), Institute of Biomedical Sciences Abel Salazar, University of Porto, Porto, Portugal
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Alam T, Abbas Z, Gillani S, Mustafa SH, Ali SM, Khan M. Comparison Of Positivity Of Tuberculin Skin Test With Diagnostic Bcg In Children Suffering From Tuberculosis. J Ayub Med Coll Abbottabad 2020; 32:204-207. [PMID: 32583995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
BACKGROUND Tuberculosis is major public health problem in Pakistan and it is often unrecognized cause of morbidity and mortality in children living in endemic areas. Children with age less than 5 years, and especially those who are immune compromised, are at higher risk of developing tuberculosis following exposure. Tuberculosis in children is usually difficult to diagnose compare to adult patients due to its atypical presentation. Tuberculin skin test and Bacille Calmette-Guerin (BCG) are widely used as diagnostic tests for tuberculosis. It was a Cross sectional study carried out from May 2017 to Nov 2018 in the department of Paediatrics, Ayub Teaching Hospital Abbottabad.. METHODS Both BCG and tuberculin skin test were performed at the same time by the same doctor. Personal data like age, gender and address, type of tuberculosis, positivity of tuberculin skin test and positivity of diagnostic BCG were recorded. The induration was read 48- 72 hours after administration. RESULTS As per frequencies and percentages for positivity of tuberculin skin, 51 (67.10%) patients showed positivity for tuberculin skin while 71 (93.42%) patients showed positive results via BCG Test. CONCLUSIONS In paediatric age group, diagnostic BCG test has got better diagnostic value over Tuberculin Skin Test in diagnosis of tuberculosis.
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Affiliation(s)
- Tariq Alam
- Department of Paediatrics, DHQ Hospital, Tank
| | - Zaheer Abbas
- Department of Paediatrics, Ayub Medical Complex, Abbottabad, Pakistan
| | - Saima Gillani
- Department of Paediatrics, Ayub Medical Complex, Abbottabad, Pakistan
| | | | - Syed Maisam Ali
- Department of ENT, Ayub Medical Complex, Abbottabad, Pakistan
| | - Mehreen Khan
- Department of Paediatrics, Ayub Medical Complex, Abbottabad, Pakistan
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Reviono R, Saptawati L, Redhono D, Suryawati B. Good Agreement between an Interferon Gamma Release Assay and Tuberculin Skin Tests in Testing for Latent Tuberculosis Infection among HIV-Infected Patients in Indonesia. J Korean Med Sci 2019; 34:e259. [PMID: 31625291 PMCID: PMC6801227 DOI: 10.3346/jkms.2019.34.e259] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Accepted: 08/20/2019] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Latent tuberculosis infection is a condition where there is a persistent immune response to Mycobacterium tuberculosis without clinical manifestations of tuberculosis. Currently, there is no gold standard to diagnose latent tuberculosis infection. The tuberculin skin test and interferon-gamma release assay are currently used to diagnose latent tuberculosis infection. However, studies have shown inconsistencies regarding the level of agreement between these tests in different settings. In this study, we aimed to evaluate the agreement between these two tests for diagnosing latent tuberculosis infection in human immunodeficiency virus (HIV)-infected individuals. METHODS We screened HIV patients with no clinical symptoms of tuberculosis, a normal chest X-ray, and no history of tuberculosis or use of antituberculous drugs. Participants were tested with tuberculin skin test (TST) and T-SPOT.TB (an interferon gamma release assay) simultaneously. Participants' HIV stage was determined by measuring the level of CD4+ T-lymphocytes. Tuberculosis status was confirmed by sputum examination using GeneXpert. The level of agreement between the TST and T-SPOT.TB results was measured using Cohen's κ coefficient. RESULTS Of the 112 participants, 20 had a positive T-SPOT.TB test result, and 21 had a positive TST result. The TST and T-SPOT.TB test results showed a high level of agreement (κ = 0.648, P < 0.001). Performance of the tests did not vary with CD4+ level. However, in participants with CD4+ < 200 cells/mm³, T-SPOT.TB detected more latent tuberculosis infections than the TST. CONCLUSION There was good agreement between the TST and T-SPOT.TB results of latent tuberculosis infection in participants. TST is the preferred test for diagnosing latent tuberculosis infection in HIV-infected patients, especially in resource-limited settings, because it is simple and cost-effective. However, T-SPOT.TB may be useful to rule out latent tuberculosis infection in patients with severe immunodeficiency.
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Affiliation(s)
- Reviono Reviono
- Department of Pulmonology and Respiratory Medicine, Faculty of Medicine/Moewardi Hospital, Universitas Sebelas Maret, Surakarta, Republic of Indonesia.
| | - Leli Saptawati
- Department of Microbiology, Faculty of Medicine, Universitas Sebelas Maret, Surakarta, Republic of Indonesia
| | - Dhani Redhono
- Department of Internal Medicine, Faculty of Medicine/Moewardi Hospital, Universitas Sebelas Maret, Surakarta, Republic of Indonesia
| | - Betty Suryawati
- Department of Microbiology, Faculty of Medicine, Universitas Sebelas Maret, Surakarta, Republic of Indonesia
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Arias-Guillén M, Sánchez Menéndez MM, Alperi M, Riestra S, González Budiño MT, García-Clemente MM, Martínez-González S, Enríquez AI, Alonso-Arias R, Palacios Gutiérrez JJ, Santibáñez M, Coto-Segura P, Camblor PM, García-Alfonso L, Morante I, Escalante P. High rates of tuberculin skin test positivity due to methotrexate therapy: False positive results? Semin Arthritis Rheum 2018; 48:538-46. [PMID: 29735171 DOI: 10.1016/j.semarthrit.2018.03.018] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2017] [Revised: 03/01/2018] [Accepted: 03/26/2018] [Indexed: 11/20/2022]
Abstract
RATIONALE The tuberculin skin test (TST) and interferon ? release assays (IGRAs) are commonly used for latent tuberculosis infection (LTBI) screening. Unexpectedly high TST positivity rates have been reported in patients with rheumatic diseases, and methotrexate is frequently used in this population. We hypothesized that methotrexate use could be associated with false-positive TST results. OBJECTIVES To investigate whether treatment with methotrexate and other factors are associated with false-positive TST results in patients with rheumatic diseases. METHODS Prospective single-center study conducted between April 2013 and March 2016. Adult patients with rheumatic diseases were evaluated with a TST and two IGRAs for LTBI screening. We compared TST and IGRA results in patients treated and not treated with methotrexate and analyzed for factors associated with positive TST results. CONCLUSIONS Our data suggest false-positive TST results associated with methotrexate therapy. Thus, we recommend against using the TST for LTBI screening in patients receiving methotrexate and the preferential use of IGRAs in such patients. MEASUREMENTS AND MAIN RESULTS We studied 393 patients with rheumatic diseases, including ankylosing spondylitis (ASP, n = 90), rheumatoid arthritis (RA; n = 120), psoriatic arthritis (PA, n = 126), and other disorders (n = 57). The rate of TST positivity varied across the groups: ASP 22.2%, RA 25%, PA 35.7%, and other disorders (22.8%). Positivity rates were lower with IGRAs. Methotrexate use was associated with a statistically significant two-fold increase in the risk of a positive TST and a dose\x96 response relationship was observed. We found no statistically significant associations between methotrexate use and IGRA test positivity.
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Balkhy HH, El Beltagy K, El-Saed A, Aljasir B, Althaqafi A, Alothman AF, Alshalaan M, Al-Jahdali H. Prevalence of Latent Mycobacterium Tuberculosis Infection (LTBI) in Saudi Arabia; Population based survey. Int J Infect Dis 2017; 60:11-16. [PMID: 28392316 DOI: 10.1016/j.ijid.2017.03.024] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2016] [Revised: 03/22/2017] [Accepted: 03/31/2017] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND The annual risk of tuberculosis infection (ARTI) data in Saudi Arabia has not been updated since 1993. OBJECTIVES To estimate the prevalence of latent TB infection (LTBI) and ARTI in a population-based sample in Saudi Arabia using Tuberculin skin test (TST) and QuantiFERON TB Gold in tube (QFT-GIT) test. METHODS A population-based cross sectional study was conducted between July 2010 and March 2013. Participants were randomly selected from the population served by the primary healthcare centers of the Ministry of National Guard Health Affairs in Riyadh, Jeddah, Alhassa and Dammam, Saudi Arabia. RESULTS A total of 1369 participants were included. The overall prevalence of LTBI was similar using TST and QFT-GIT (9.3% and 9.1% respectively, p=0.872) but stratified prevalence rates were variable in all sociodemographic groups except marital status. Additionally, the prevalence rates of LTBI using either test alone showed significant differences by several sociodemographic and behavioral characteristics. The overall ARTI was 0.36% using TST and 0.35% using QFT-GIT. CONCLUSIONS We are reporting much lower estimates for the prevalence of LTBI and the ARTI in a population-based sample in Saudi Arabia relative to the data that have been used for more than two decades.
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Affiliation(s)
- Hanan H Balkhy
- King Saud Bin Abdulaziz University for Health Sciences, Ministry of National Guard Health Affairs, Kingdom of Saudi Arabia; King Abdullah International Medical Research Center, Ministry of National Guard Health Affairs, Kingdom of Saudi Arabia; Infection Prevention and Control Department, King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Saudi Arabia.
| | - Kamel El Beltagy
- Infection Prevention and Control Department, King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Saudi Arabia; Public health & Community Medicine Department, Faculty of Medicine, Tanta University, Egypt
| | - Aiman El-Saed
- Infection Prevention and Control Department, King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Saudi Arabia; Public health & Community Medicine Department, Faculty of Medicine, Mansoura University, Egypt
| | - Badr Aljasir
- King Saud Bin Abdulaziz University for Health Sciences, Ministry of National Guard Health Affairs, Kingdom of Saudi Arabia; Preventive Medicine Department, King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Saudi Arabia
| | - Abdulhakeem Althaqafi
- King Saud Bin Abdulaziz University for Health Sciences, Ministry of National Guard Health Affairs, Kingdom of Saudi Arabia; Infection Prevention and Control Department, King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Saudi Arabia
| | - Adel F Alothman
- King Saud Bin Abdulaziz University for Health Sciences, Ministry of National Guard Health Affairs, Kingdom of Saudi Arabia; Department of Medicine, King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Saudi Arabia
| | - Mohammad Alshalaan
- King Saud Bin Abdulaziz University for Health Sciences, Ministry of National Guard Health Affairs, Kingdom of Saudi Arabia; Department of Pediatrics, King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Saudi Arabia
| | - Hamdan Al-Jahdali
- King Saud Bin Abdulaziz University for Health Sciences, Ministry of National Guard Health Affairs, Kingdom of Saudi Arabia; Department of Medicine, King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Saudi Arabia
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Durando P, Garbarino S, Orsi A, Alicino C, Dini G, Toletone A, Ciprani F, Conte G, Santorsa R, Icardi G. Prevalence and predictors of latent tuberculosis infection among Italian State Policemen engaged in assistance to migrants: a national cross-sectional study. BMJ Open 2016; 6:e012011. [PMID: 27697871 PMCID: PMC5073613 DOI: 10.1136/bmjopen-2016-012011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES Better knowledge about tuberculosis (TB) and latent TB infection (LTBI) epidemiology is a crucial step for the development of effective strategies towards the control and elimination of this deadliest and persistent health threat. No study has investigated LTBI epidemiology in policemen who act as an interface with cross-border migrants. METHODS A survey to measure the LTBI prevalence and assess the demographic, professional and clinical features potentially associated with tuberculin skin test (TST) positivity was performed in Italian State Police (ISP) employees engaged, even occasionally, in relief activities, hospitality, photographical identification, escorting and accompanying of migrants, regardless of contact with active TB cases. Variables potentially associated with TST positivity were evaluated with univariate and multivariate analysis. RESULTS From September to December 2014, 4225 ISP workers underwent TST screening and completed the questionnaire for data collection, according to study procedures. The TST was positive in 9.9% of individuals: no active TB cases were registered among the entire study population. Age, previous BCG vaccination and work category resulted independently associated with TST positivity. CONCLUSIONS This is the first study providing updated data about LTBI epidemiology among ISP employees engaged in assistance to migrants and furnish preliminary evidence of possible associations between TST positivity and different conditions that need to be deeply investigated with prospective studies.
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Affiliation(s)
- Paolo Durando
- Department of Health Sciences, University of Genoa, Genoa, Italy
- IRCCS AOU San Martino—IST, Genoa, Italy
| | - Sergio Garbarino
- Department of Health Sciences, University of Genoa, Genoa, Italy
- State Police Health Service Department, Ministry of Interior, Rome, Italy
| | - Andrea Orsi
- Department of Health Sciences, University of Genoa, Genoa, Italy
- IRCCS AOU San Martino—IST, Genoa, Italy
| | | | - Guglielmo Dini
- Department of Health Sciences, University of Genoa, Genoa, Italy
| | | | - Fabrizio Ciprani
- State Police Health Service Department, Ministry of Interior, Rome, Italy
| | - Giuseppe Conte
- State Police Health Service Department, Ministry of Interior, Rome, Italy
| | - Roberto Santorsa
- State Police Health Service Department, Ministry of Interior, Rome, Italy
| | - Giancarlo Icardi
- Department of Health Sciences, University of Genoa, Genoa, Italy
- IRCCS AOU San Martino—IST, Genoa, Italy
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Sayyahfar S, Karimi A, Fahimzad A, Shamshiri AR. Comparison of Tuberculin Skin Test result and interferon gamma response to human PPD in BCG scar positive and negative children. J Epidemiol Glob Health 2014; 4:45-50. [PMID: 24534335 PMCID: PMC7320400 DOI: 10.1016/j.jegh.2013.09.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2013] [Revised: 09/01/2013] [Accepted: 09/03/2013] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND The aim of this study is to compare Tuberculin Skin Test (TST) result and interferon gamma response to human PPD (purified protein derivative), in scar positive and scar negative BCG-vaccinated children. METHODS Between August 2007 and May 2008 a total of 236 children aged 1-168 months (mean 21 months) admitted to Mofid Children's Hospital, Tehran, Iran, were enrolled in a cross-sectional study. Each patient was examined for BCG vaccine scar and tested with TST and human PPD-based Interferon Gamma Release Assay (IGRA). RESULTS Two hundred and twenty one cases out of 236 (44% female, 1-168 months, mean age 21 months) were scar positive of whom 95% TST result was negative. Human PPD-based IGRA was positive in 110 (49.8%), negative in 85 (38.4 %) and indeterminate in 26 (11.8%) of scar positive patients. Fifteen children (40% female, 1-156 months; mean age 42 months) were scar negative. All the scar negative cases were TST negative. Human PPD-based IGRA was positive in 10 (66.7%), negative in 4 (26.7%) and indeterminate in 1 (6.7%) of scar negative patients. CONCLUSIONS Immune responsiveness to human PPD antigens in scar positive and negative children may not correspond with results of the Tuberculin Skin Test.
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Affiliation(s)
- Shirin Sayyahfar
- Division of Pediatric Infectious Diseases, Department of Pediatrics, Ali Asghar Children Hospital, Iran University of Medical Sciences, Tehran, Iran.
| | - Abdollah Karimi
- Division of Pediatric Infectious Diseases, Pediatric Infectious Research Center(PIRC), Mofid Children Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Alireza Fahimzad
- Division of Pediatric Infectious Diseases, Pediatric Infectious Research Center(PIRC), Mofid Children Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ahmad Reza Shamshiri
- Dentistry Research Institute, Department of Community Oral Health, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
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Hemmati M, Ghadiri K, Rezaei M. Tuberculin Reactivity in School Age Children; Five-year Follow-up in Iran. Iran J Pediatr 2011; 21:39-44. [PMID: 23056762 PMCID: PMC3446104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/12/2010] [Revised: 06/26/2010] [Accepted: 09/17/2010] [Indexed: 10/27/2022]
Abstract
OBJECTIVE Tuberculosis (TB) is an important infectious disease worldwide. Tuberculin skin test (TST) is the standard test for diagnosis of tuberculosis infection; Bacillus Calmette-Guerin (BCG) vaccination at birth has effects on this test. The aim of this study was to determine the prevalence of positive TST cases among 7- to 11-year-old primary school children and also to follow test-positive individuals for a five-year period. METHODS TST was performed on 10.184 children aged 7-11 years sampled by cluster random method in Kermanshah, West Iran. Those who had a positive test result (i.e. an induration of ≥15 mm following 72 hours of injecting 0.1 ml of 5 tuberculin units of purified protein derivative from Mycobacterium tuberculosis) were followed for five years to determine the presence of active TB. Also tuberculin positive rates at cut-off points of 10 mm and ≥15 mm for boys and girls and at different ages were derived and compared using the chi-squared test. FINDINGS Of 10.184 studied subjects, 830 (8.15%) cases showed positive TST. This rate was 8.7% in boys and 7.8% in girls (P=0.1). A significant linear trend was found between the tuberculin positive rates and age at all cut-off points (P<0.001). No active TB was detected during 5-year follow-up. CONCLUSION The rate of positive TST cases in primary school children in Kermanshah, Iran was 8.15% with no new cases of active tuberculosis detection within five-year follow-up.
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Affiliation(s)
| | - Keyghobad Ghadiri
- Corresponding Author: Address: mam Reza Hospital, Kermanshah, Iran. E-mail:
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