Is tuberculin skin testing useful to diagnose latent tuberculosis in BCG-vaccinated children?

F, Ma. Cecilia García-Sancho; García-García, Lourdes; Jiménez-Corona, Ma Eugenia; Palacios-Martínez, Manuel; Ferreyra-Reyes, Leticia; Canizales-Quintero, Sergio; Cano-Arellano, Bulmaro; Ponce-de-León, Alfredo; Sifuentes–Osornio, José; Small, Peter M.; DeRiemer, Kathryn

doi:10.1093/ije/dyl213

Cited by 20 publications

(19 citation statements)

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“…Analyses using different results combination allowed us to show consistency of the association. Odds ratio was found to be higher when a more specific combination was used (IGRA and TST positive compared with IGRA and TST negative results) [26].…”

Section: Discussionmentioning

confidence: 91%

Prevalence of Latent and Active Tuberculosis among Dairy Farm Workers Exposed to Cattle Infected by Mycobacterium bovis

et al. 2013

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BackgroundHuman tuberculosis caused by M. bovis is a zoonosis presently considered sporadic in developed countries, but remains a poorly studied problem in low and middle resource countries. The disease in humans is mainly attributed to unpasteurized dairy products consumption. However, transmission due to exposure of humans to infected animals has been also recognized. The prevalence of tuberculosis infection and associated risk factors have been insufficiently characterized among dairy farm workers (DFW) exposed in settings with poor control of bovine tuberculosis.Methodology/Principal FindingsTuberculin skin test (TST) and Interferon-gamma release assay (IGRA) were administered to 311 dairy farm and abattoir workers and their household contacts linked to a dairy production and livestock facility in Mexico. Sputa of individuals with respiratory symptoms and samples from routine cattle necropsies were cultured for M. bovis and resulting spoligotypes were compared. The overall prevalence of latent tuberculosis infection (LTBI) was 76.2% (95% CI, 71.4–80.9%) by TST and 58.5% (95% CI, 53.0–64.0%) by IGRA. Occupational exposure was associated to TST (OR 2.72; 95% CI, 1.31–5.64) and IGRA (OR 2.38; 95% CI, 1.31–4.30) adjusting for relevant variables. Two subjects were diagnosed with pulmonary tuberculosis, both caused by M. bovis. In one case, the spoligotype was identical to a strain isolated from bovines.ConclusionsWe documented a high prevalence of latent and pulmonary TB among workers exposed to cattle infected with M. bovis, and increased risk among those occupationally exposed in non-ventilated spaces. Interspecies transmission is frequent and represents an occupational hazard in this setting.

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Section: Discussionmentioning

confidence: 91%

Prevalence of Latent and Active Tuberculosis among Dairy Farm Workers Exposed to Cattle Infected by Mycobacterium bovis

et al. 2013

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“…16 Figure 1 identify children in a BCG-vaccinated population who had recent exposure to persons with pulmonary TB, and were probably infected with M. tuberculosis. 20 We considered the Mantoux test to be positive for subjects. A study in Hamburg, Germany compared a Mycobacterium tuberculosis-specific enzyme-linked immunospot (ELISPOT) assay to the tuberculin test.…”

Section: Discussionmentioning

confidence: 99%

Mantoux test results and BCG vaccination status in TB-exposed children

Harahap

Daulay

Ali

et al. 2015

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“…Studies by Silva VMC [22] et al and Srour-Fihmi S et al [23] in age groups ranging from 20 years to over 60 years have shown that being BCG vaccinated had no effect on the booster response. Studies also show that the effect of BCG is insignificant when TST reactions are ≥ 10mm [5,6,18,24–26]. …”

Section: Discussionmentioning

confidence: 99%

Two-Step Tuberculin Skin Testing in School-Going Adolescents with Initial 0-4 Millimeter Responses in a High Tuberculosis Prevalence Setting in South India

Murthy

Selvam²,

Jesuraj³

et al. 2013

PLoS ONE

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BackgroundThe utility of two-step tuberculin skin testing among adolescents in high tuberculosis prevalence settings is not well established.ObjectivesTo determine the proportion and determinants of a 0-4 mm response to an initial standard tuberculin skin test (TST) and evaluating 'boosting' with repeat testing.MethodsAdolescents between 11 and 18 years attending schools/colleges underwent a TST; those with a response of between 0–4 mm had a repeat TST 1-4 weeks later.ResultsInitial TST was done for 6608/6643 participants; 1257 (19%) developed a 0-4 mm response to the initial TST. Younger age and under-nutrition were more likely to be associated with a 0-4 mm response, while the presence of BCG (Bacillus Calmette Guerin) scar and higher socio-economic class were less likely to be associated with a 0-4 mm response. On repeat testing boosting was seen in 13.2% (145/1098; ≥ 6 mm over the initial test) while 4.3% showed boosting using a more conservative cutoff of a repeat TST ≥ 10 mm with an increment of at least 6 mm (47/1098). History of exposure to a tuberculosis (TB) case was associated with enhanced response.ConclusionThe proportion of adolescents who demonstrated boosting on two-step TST testing in our study was relatively low. As a result repeat testing did not greatly alter the prevalence of TST positivity. However, the two-step TST helps identify individuals who can potentially boost their immune response to a second test, and thus, prevents them from being misclassified as those with newly acquired infection, or tuberculin converters. While two-step tuberculin skin testing may have a limited role in population- level TST surveys, it may be useful where serial tuberculin testing needs to be performed to distinguish those who show an enhanced response or boosters from those who indeed have a new infection, or converters.

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Is tuberculin skin testing useful to diagnose latent tuberculosis in BCG-vaccinated children?

Abstract: TST results helped identify children in a BCG-vaccinated population who had recent exposure to persons with pulmonary tuberculosis, were probably infected with M. tuberculosis, and could benefit from treatment for their latent tuberculosis infection.

Cited by 20 publications

References 22 publications

Prevalence of Latent and Active Tuberculosis among Dairy Farm Workers Exposed to Cattle Infected by Mycobacterium bovis

Prevalence of Latent and Active Tuberculosis among Dairy Farm Workers Exposed to Cattle Infected by Mycobacterium bovis

Mantoux test results and BCG vaccination status in TB-exposed children

Two-Step Tuberculin Skin Testing in School-Going Adolescents with Initial 0-4 Millimeter Responses in a High Tuberculosis Prevalence Setting in South India

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