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At least 217 records · Page 12Linked to original sources
PubMed2004

Neonatal BCG vaccine and response to the tuberculin test in BCG vaccinated children in contact with tuberculosis patients in Recife, Brazil.

This case-control study analyses the association between the tuberculin response and the neonatal BCG vaccine in 330 children under 15 who are home contacts of tuberculosis patients, taking into account risk factors for the transmission of infection. Interviews were conducted with 330 children, their parents or legal guardians. Chest X-rays were taken and the tuberculin test (TT) applied using 0.1 ml of PPD RT23, taking an induration reading of > or = 10 mm as the cut-off point for a positive test result. Prior BCG vaccination was ascertained by observing the presence of a scar on the deltoid region of the right arm. Six children were excluded because they had signs/symptoms of pulmonary tuberculosis, thereby reducing the final sample to 324 children. The multivariate analysis showed that being exposed to a patient with pulmonary lesions with cavities (OR = 3.14; CI: 1.59-6.20; p = 0.000), a positive sputum smear (OR = 3.65; CI: 1.52-8.78; p = 0.002) or a positive culture (OR = 4.42; CI: 1.39-14.1; p = 0.005), being under five (OR = 0.47; CI: 0.22-0.99; p = 0.045) are independently associated with a positive TT. The fact that a prior BCG scar is not associated with a positive response to the TT indicates the need to re-open discussion of the guidelines which exist in many poor countries where tuberculosis is still a serious public health problem. Such guidelines include those issued by the Brazilian Ministry of Health, which considers the child under 15 in contact with a tuberculosis case to be infected only if there is a TT of 10 mm or more and the child received no prior BCG vaccination.

Adolescent↗
PubMed1989

The nonutility of chest roentgenographic examination in asymptomatic patients with positive tuberculin test results.

To determine the value of chest roentgenograms in the management of asymptomatic persons with positive tuberculin skin test results, we undertook a retrospective review of all tests administered by our Employee Health Service, North Shore University Hospital, Manhasset, NY, between July 1, 1983 and November 1, 1987. Of 5200 tests, 247 results were positive. Two hundred twenty-one of these charts were reviewed for roentgenographic results and the presence of symptoms. All persons were asymptomatic. Chest roentgenograms revealed the following: normal, 188; unrelated abnormalities, 24; apical pleural thickening, 5; granulomas, 2; calcified hilar node, 1; and calcified node plus granuloma, 1. We noted no active tuberculosis, nor did the chest roentgenographic results influence recommendations for isoniazid prophylaxis. We conclude that chest roentgenograms are of value in 0% to 1.3% of asymptomatic people with positive tuberculin test results. A larger study should be undertaken to further define the usefulness of chest roentgenograms in this population.

Adult↗
PubMed1995

The evolution of targeted populations in a school-based tuberculin testing program.

A review of tuberculosis surveillance data from a program of school-based tuberculin testing demonstrates the natural evolution of targeted populations. In the 7 years encompassed by this study, the prevalence of tuberculin reactivity ranged from 4.3% to 6.1% in the Amarillo public school populations which were tested. The initial screening was a sampling of all students in the school district. In subsequent years' screening, the targeted populations were increasingly refined to eliminate lower-risk populations. Children enrolled in "English as a Second Language" (ESL) classes were found to have an 8.5% tuberculosis infection rate. The purpose of this study was to alert nurses that culturally sensitive approaches are needed for successful future testing.

Asia↗
PubMed1993

[Interobserver agreement in reading tuberculin tests].

BACKGROUND: The aim of the study was to evaluate the variability between four observers in the reading of the tuberculin test (TT). METHODS: The study was carried out in the Centro de Salud Mendiguchía Carriche (Madrid) 72 subjects. By direct inspection, four observers read tuberculin determination (skin induration) independently in each subject. To assess variability, the kappa index (K) was calculated. RESULTS: On considering the variable as a dichotomous one, with a cut-off point of 5 mm was 0.88; and of 10 mm, 0.78. Upon considering the index as qualitative in four categories the kappa index in 0 mm was 0.89; in 1-4 mm, 0.24; in 5-9 mm, 0.40 and greater than 9 mm, 0.79. In eight of the subjects studied, the variability observed in reading the test had conditioned further different clinico-epidemiologic attitudes. CONCLUSIONS: The degree of concordance when reading TT is significantly lower at the 1-4 mm and 5-9 mm intervals.

Adolescent↗
PubMed1991

Histometric studies on cellular infiltrates of tuberculin tests in patients with sarcoidosis.

The density and microanatomical location of CD4 and CD8 lymphocytes and of monocytes/macrophages at the site of a tuberculin test were measured in 13 patients with sarcoidosis, and the results were compared with those seen in a group of healthy controls. The cellular infiltrate was significantly reduced in the sarcoid subjects compared with the controls for all cell phenotypes studied; the ratio of CD4 positive:CD8 positive lymphocytes was significantly increased in the sarcoid group. Clinically negative reactions showed substantial numbers of infiltrating mononuclear cells, although not as great as in clinically apparent reactions. A clinically negative tuberculin reaction does not necessarily imply anergy to the test substance and should not be termed "negative".

Adult↗
PubMed2000

Density of tuberculin skin reaction and its association with tuberculosis infection as defined by dual tuberculin testing.

OBJECTIVE: To determine whether the density of tuberculin skin reactions is associated with tuberculosis infection. METHODS: In a national tuberculin survey in Tanzania, 1983-1987, all eligible children in a random sub-sample of schools underwent dual tuberculin skin testing with PPD-RT23 and PPD-scrofulaceum. The density of reactions to RT23 was classified as proposed by Palmer. A larger reaction to PPD-scrofulaceum than to PPD-RT23 is suggestive of infection with environmental mycobacteria. Tuberculosis infection was defined based on dual skin test results applying a range of possible definitions. RESULTS: A total of 10,782 children aged 5-14 years and without BCG scar were included in the analysis. Large skin reactions to RT23 were generally firmer than small ones. After taking the size of the skin reaction to RT23 into account, its density was not associated with the size of the skin reaction against PPD-scrofulaceum. In particular, the density of reactions in the range 6-11 mm was not associated with tuberculosis infection according to any of the definitions used. CONCLUSION: This study suggests that the density of reaction was not associated with tuberculosis infection in Tanzanian school children after taking the size of the induration into account.

Child↗
PubMed1984

[Tuberculin tests and the incidence of tuberculosis in students. Experiences from the Basle school health service].

15-year-old reactors to intradermic tuberculin tests were analized over the period from 1976 to 1983 to assess the prevalence of tuberculosis in this age group. The proportion of children with BCG vaccination increased in the observation period from 34% to 49%. The rate of spontaneous tuberculin convertors has therefore to be calculated as a proportion of the non-vaccinated children only. During the years 1976-1983, this rate was between a minimum of 6.3% and maximum 14.5%. Since the children had not been tested for four years previously, an incidence between 1.5 an 3% can be calculated for this age group.

Adolescent↗