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PubMed1997

Performance of the single intradermal comparative tuberculin test in identifying cattle with tuberculous lesions in Irish herds.

The sensitivity of the single intradermal comparative tuberculin test, as applied in the Republic of Ireland, was estimated in 353 cattle with tuberculous lesions. These cattle had been removed from 47 herds which were depopulated owing to chronic or extensive infection with Mycobacterium bovis. The test had a sensitivity of 90.9 per cent, because 321 (90.9 per cent) of the 353 cattle with tuberculous lesions gave a positive or inconclusive result, and 32 gave a negative result. These 32 negative cattle came from 17 (36 per cent) of the 47 depopulated herds.

Animals↗
PubMed1990

The influence of Calmette-Guérin bacillus immunization on the booster effect of tuberculin testing in healthy young adults.

The booster or enhancement effect of repeated tuberculin skin testing in Calmette-Guérin bacillus (BCG)-vaccinated young adults was studied in 208 first-year medical, nursing, and medical technology students in Santiago, Chile, where BCG vaccine is usually administered at birth and at 6 and 14 yr of age. Thirty-three students had no BCG scar, 62 had one scar, 71 had two scars, and 42 had three scars. The mean age for each group was 19 yr. All students were healthy and had no known exposure to tuberculosis or history of tuberculosis or other mycobacterioses. The size in millimeters of induration of the first tuberculin reaction (PPD1) was clearly correlated with the number of BCG scars: 2.3 +/- 4.6 for no scars; 6.7 +/- 6.7 for one scar; 10.9 +/- 5.9 for two scars, and 13.2 +/- 5.3 for three scars. The second tuberculin reaction (PPD2), performed 2 wk later on the contralateral forearm, showed a marked increase in reactivity. The increase in reaction size was most evident in students who had BCG scars but who were initially PPD negative (less than 10 mm). Smaller increases were observed in students without BCG scars, and also in those who had BCG scars but who were initially tuberculin positive (greater than or equal to 10 mm). The persistence of the booster effect was evaluated by performing PPD3 1 yr later. PPD1-negative students with BCG scars maintained the increased level of reactivity to PPD2 after 1 yr. An immunizing effect of tuberculin testing was suggested in 11 nonimmunized students who were initially PPD negative.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1996

Tuberculin testing in two Liverpool social clubs: the effects of a tuberculosis outbreak on background positivity.

BACKGROUND: Tuberculin testing remains the standard method for assessing infection due to tuberculosis in the UK. However, there are no data on the incidence of tuberculin positivity among the general adult population in the UK and consequently interpretation of Heaf test results is often difficult. METHODS: During the investigation of an outbreak of tuberculosis in a Liverpool social club 198 members were interviewed and Heaf tested and 171 members of a second social club in Liverpool were similarly screened as a control group. Comparisons between the results from the two populations provided both an estimate of baseline Heaf test positivity in indigenous white adults from a British inner city population, and a measure of the effect on this baseline of recent exposure to tuberculosis. RESULTS: In both club populations the proportion of positive Heaf tests increased with age. Independent of age, the tuberculosis exposed population had a higher proportion of positive Heaf grade results (40.9%) than those in the control group (26.9%). Multivariate analysis confirmed both the differences in Heaf results between clubs and between age groups but identified no other behavioural or medical factors which affected Heaf test results. CONCLUSIONS: Heaf test positivity increases with age at least up to 54 years, and recent exposure to tuberculosis increases the proportion of positive Heaf tests in each age group. Interpretation of positive Heaf tests when assessing the effects of a tuberculosis outbreak should take account of background levels of Heaf positivity.

Adolescent↗
PubMed1987

Two-stage tuberculin testing with control antigens in patients residing in two chronic disease hospitals.

We studied the prevalence of tuberculin reactivity and anergy in 360 elderly patients residing in two municipal chronic disease hospitals. Eighty-five (26%) of the 323 patients tested had a positive reaction to a stage 1 tuberculin test and 12 (6%) of the 207 stage 1 tuberculin-negative patients exhibited a booster response to a stage 2 tuberculin test. Thirty percent of the same 207 patients had no response to an anergy panel of skin test antigens that included candida, mumps, and trichophyton. Nonresponders to tuberculin and the anergy panel had significantly higher one-year mortality rates compared to responders (44 v 20%, P = 0.001). Tuberculin-positivity among the 770 employees working in these facilities was 43%; 12 (4%) had a booster response. A survey of 29 randomly selected long-term care facilities in the Boston area indicated that all had a policy for pre-employment screening of employees, but less than 50% had a policy for patients and only one institution used two-stage testing. Routine tuberculin testing is recommended for long-term care facilities and the two-stage method is preferable in institutions with adequate resources.

Adult↗
PubMed1990

The booster effect with repeat tuberculin testing in children and its relationship to BCG vaccination.

One hundred and twenty-seven children, aged 6 months - 14 years, attending a day-care centre in Pretoria had two Mantoux tuberculin tests performed 8 weeks apart. On initial testing 19.7% of the children had reactions greater than or equal to 10 mm and positive tests were commoner in the older children--who had received BCG vaccination twice. On repeat testing a significant increase in the mean tuberculin reaction size was noted and 13% of the children converted to tuberculin positivity. Since an extensive search revealed no evidence of active tuberculosis in either children or adults at the day-care centre, it was concluded that the observed enhancement of the tuberculin reactions was due to the booster effect. This phenomenon was most marked in preschoolers with a BCG scar. It is important to recognise that boosting can occur in children and may be confused with true conversion to tuberculin positivity caused by infection with Mycobacterium tuberculosis.

Adolescent↗
PubMed1987

Significance of the tuberculin test in the elderly.

Nine hundred thirty-three persons over 65 years of age, residing in long-term or extended-care facilities in Vancouver, Canada, had tuberculin tests. In addition to PPD-tuberculin, 5 TU and 250 TU, we used PPD-Battey, Candida albicans, mumps, and Trichophyton antigens. Twenty-five percent reacted to 5 TU of tuberculin with reactions of 10 mm or more. There was a progressive, substantial loss of reactivity with advancing age. Reactions to PPD-Battey greater than to PPD-T 5 TU were infrequent, suggesting that atypical mycobacterial infections were uncommon and that positive reactions to PPD-T, 250 TU, were predominantly caused by infections with Mycobacterium tuberculosis. Based on the results of both 5 TU and 250 TU, the prevalence of tuberculous infection exceeded 60 percent. Waning of tuberculin sensitivity appears to be an integral part of the aging process. Testing with nonmycobacterial antigens used in this study shed no further light on the problem of anergy in the elderly, as the number of reactors was smaller than that obtained with PPD-tuberculin.

Aged↗
PubMed1981

[BCG vaccination and/or tuberculin testing for the elimination of tuberculosis (author's transl)].

In an epidemiological an clinical pilote study the authors have done a tuberculin testing survey in combination with the mass X-ray examinations in 2553 adults in the village Dabas with 3885 inhabitants. The percentage of tuberculin positive persons of the various age groups refers to a still high infection prevalence of the adults. However, among the persons under 30 and older than 60 years a high percentage of tuberculin negative ones was found (27-38%). By reason of their investigations the increasing significance was emphasized. The authors recommend, to revise once more the practice of BCG vaccination of the persons under 30 years, a more intensive dispensaric care of the adolescent living in an infectious environment, in collectives and of all the old tuberculin-negative persons.

Adolescent↗
PubMed2005

Comparison of erythema and induration as results of tuberculin tests.

SETTING: Schoolchildren, tuberculosis (TB) patients, and hospital employees in Tokyo, Japan. OBJECTIVE: To compare erythema and induration resulting from tuberculin tests among TB patients, normal children, and hospital employees with and without evidence of atopy. DESIGN: The distributions of diameters of erythema and induration were compared among three groups: 951 TB patients, 6139 first-grade and 6185 seventh-grade children, and 97 volunteer employees classified as atopic or non-atopic on the basis of skin tests and serum immunoglobulin E (IgE) concentrations. RESULTS: Erythema and induration were highly correlated. The distribution of erythema diameters was unimodal, and the distribution of induration diameters was bimodal. Erythema was considerably greater than induration among persons classified as being atopic. CONCLUSION: Both erythema and induration appear to be adequate indices of tuberculin sensitivity. However, because most of the world uses induration as the index and virtually all studies of tuberculin sensitivity rely on induration, there are advantages in the use of induration. It would be desirable to initiate a large prospective study to see whether erythema or induration is the better predictor of subsequent tuberculous disease, and to confirm our finding that erythema is more likely to be confounded by atopy than induration.

Adult↗
PubMed2004

The effect of the tuberculin test and the consequences of a delay in blood culture on the sensitivity of a gamma-interferon assay for the detection of Mycobacterium bovis infection in cattle.

The strategic use of the gamma-interferon (IFN-gamma) assay (Bovigam) can provide a means for the early identification of Mycobacterium bovis infected cattle, thus ensuring their removal from an infected herd. It has been reported that performance of the test can be influenced by various factors including a recent tuberculin skin test and the length of delay between collection and processing of blood samples. In this study, single intradermal comparative tuberculin test (SICTT) reactor and non-reactor cattle were recruited from herds infected with M. bovis and grouped according to their SICTT responses. Group 1 comprised reactor cattle selected on the basis of their SICTT response to PPD-bovine (purified protein derivative of tuberculin) exceeding that of PPD-avian by at least 12mm. Group 2 animals were selected from herds undergoing routine surveillance for bovine tuberculosis and contained standard SICTT reactor cattle (PPD-bovine exceeding that of PPD-avian by at least 4mm) and non-reactors. We investigated the effects of the SICTT on the assay results by measuring the in vitro IFN-gamma responses of Group 1 reactor cattle at time intervals pre- and post-skin test. No significant differences were measured in the IFN-gamma responses of the reactor animals to PPD-bovine and PPD-avian for up to 65 days. To investigate if a delay in processing of blood affected the performance of the assay, we compared results using duplicate blood samples from Group 1 and Group 2 cattle stimulated with PPD antigen at 8h and at 24h after collection. In both groups of animals the mean optical density (OD) values of the assay at 24h post-collection were significantly lower than those at 8h. Our results demonstrated that a delay in processing of the blood samples from cattle subjected to routine surveillance could significantly impact on the outcome of the IFN-gamma assay resulting in a change of the IFN-gamma status of the animals.

Animals↗
PubMed1986

Measurement of skin swelling in the tuberculin test by ultrasonography.

A new method is described for non-invasive measurement of the thickness of the skin at the site of a skin test from the echo pattern of a pulsed ultrasonic (15 MHz) A-mode scanner. In tuberculin tests on normal volunteers, the skin thickness increased rapidly during days 1 and 2 and was usually greatest at day 4. The echogram measurements can be used to calculate the increase in skin volume and this is disproportionately greater than would be expected from measurements of the diameters of erythema and induration.

Adult↗
PubMed2001

Validity of intradermal tuberculin testing for the screening of bovine tuberculosis in Madagascar.

A sample survey with the objective of determining the prevalence of bovine tuberculosis by means of an intradermal tuberculin test was conducted in Madagascar and it was found that the prevalence rate varied from 0-30% by veterinary district. In order to estimate the true prevalence, the validity of the test was investigated by assessing its sensitivity and specificity in two groups of animals from two different regions, which were destined for slaughter. In the first group where the probability of non-infected animals should have been the highest, sensitivity was estimated at 0.52 (n = 21) and specificity at 0.99 (n = 79). In the second group selected on the basis of apparent ill health of the animals in a high-prevalence bovine tuberculosis area, sensitivity was estimated at 0.8 (n = 10) and specificity at 1 (n = 12). The results obtained from both groups of cattle were not combined for statistical purposes because the sensitivity of the skin test seemed to fluctuate in relation to the chronicity of the disease. These fluctuations are discussed. However, since the first group of zebu cattle was more representative of the cattle population across the country as a whole, its results were retained as operational parameters for further screening.

Animals↗