O fenomeno booster na avaliacao da prova tuberculinica cutanea (original) (raw)
Related papers
The tuberculin skin test: a comparison of ruler and calliper readings
The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease, 2010
The Mantoux tuberculin skin test (TST) is widely used to diagnose latent infection with Mycobacterium tuberculosis. TST skin induration may be measured either by a transparent ruler or by a pair of callipers. We hypothesised that the type of instrument used may affect the reading. To determine whether variability in Mantoux TST measurement is affected by the type of reading instrument. A TST (Mantoux method) was performed among healthy adolescents. The indurations were read with among ruler and calliper by two independent readers. Limits of agreement and Kappa (κ) scores at TST positivity cut-off points were calculated. A Bland-Altman graph was constructed. The 95% limits of agreement between instruments ranged from -5 mm to 3 mm. The limits of agreement between readers ranged from -5 mm to 4 mm. κ scores between instruments were respectively 0.7 and 0.8 at 15 mm and 10 mm cut-offs. The variability between readers of TST indurations is not influenced by changing the reading instrument.
Two-step tuberculin skin test and booster phenomenon prevalence among Brazilian medical students
The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease, 2008
Five medical schools in three cities in Rio de Janeiro State, Brazil, with different tuberculosis (TB) incidence rates. To evaluate the prevalence of the booster phenomenon and its associated factors in a young universally BCG-vaccinated TB-exposed population. A two-step tuberculin skin test (TST) was performed among undergraduate medical students. Boosting was defined as an induration > or =10 mm in the second TST (TST2), with an increase of at least 6 mm over the first TST (TST1). The association of boosting with independent variables was evaluated using multivariate analysis. Of the 764 participants (mean age 21.9 +/- 2.7 years), 672 (87.9%) had a BCG scar. The overall booster phenomenon prevalence was 8.4% (95%CI 6.5-10.6). Boosting was associated with TST1 reactions of 1-9 mm (aOR 2.5, 95%CI 1.04-5.9) and with BCG vaccination, mostly after infancy, i.e., after age two years (aOR 9.1, 95%CI 1.2-70.7). The prevalence of the booster phenomenon was high. A two-step TST in young ...
Journal of Tuberculosis Research, 2021
Objective: to evaluate the policy of TST testing in Suriname. As there is no gold standard to diagnose latent tuberculosis infection (LTBI), the tuberculin skin test (TST) is used to diagnose LTBI. However, internationally, the cut-off values of the TST are not uniform and depend on local tuberculosis (TB) epidemiology and guidelines for test initiation. In Suriname, where currently several indications exist for TSTs, cut-off values are set at 5 mm or 10 mm, depending on the age and/or medical history of the patient. LTBI classification is performed by pulmonologists primarily based on the American Thoracic Society targeted TB testing guidelines. Method: retrospective analysis of outpatient TST data between 2011 and 2019 from Suriname’s sole pulmonary medicine clinic. Result: 1373 patients were evaluated. 590 patients were from the screening group of whom 253 had a positive TST result, 46 of whom were classified as LTBI. In the contact tracing group of 649 patients, 616 had a positi...
Cases Journal, 2008
Background: Tuberculosis remains a serious disease worldwide. Anti-tuberculosis campaigners many times face negative tuberculin skin tests after Bacille Calmette Guérin vaccination. Increasing tuberculin units might be a solution. However, is skin reaction a linear function of tuberculin dose? Are there any side-effects when higher tuberculin doses are administered? Case presentation: Six simultaneous Mantoux tuberculin skin tests, using 1, 2, 5, 10, 20, and 50 tuberculin units (88 altogether) of purified protein derivative RT23 per 0.1 mL were applied in a healthy male Greek 35-years-old, with known natural Mycobacterium tuberculosis primary infection since five years. Skin indurations 72 hours later were 15, 22, 23, 19, 23, and 27 mm respectively. Conclusion: No linear relation between tuberculin dose and skin reaction observed; skin reaction increased as tuberculin dose increased but with a decreasing rate, especially after 2 TUs, which seem correctly defined for detection of natural infection. No side-effects occurred.
Patient's Self-interpretation of Tuberculin Skin Tests
Chest, 1996
Background: In the outpatient use of tuberculin skin testing (purified protein derivative [PPD]), it is at times inconvenient to have a patient revisit for interpretation. Therefore, we assessed patients' ability to self-interpret these test results. Methods: In keeping with prior custom, patients were seen by an experienced nurse, who performed skin testing with PPD intermediate strength as well as mumps and Candida anergy control tests in some cases, and explained the procedure. The patients were asked to return 48 to 72 h later, at which time one ofthe researchers recorded their test interpretations before they were again evaluated by the nurse. Results: Sixty-eight patients were studied, of whom 59 returned at appropriate interval. Eighteen patients had a positive PPD test reaction of 10 to 20 mm induration, which only one patient correctly identified as a positive test result. However, positive anergy control tests were correctly interpreted in 10 of 27 cases. Conclusion: The small number of positive PPD test result recognition by these patients may be partially attributed to their lack of education, as well as foreign birth and denial of illness. PPD re¬ sults should be checked by an experienced professional.
Comparative Tuberculin-testing of Human Subjects
BMJ, 1961
From the East Suffolk and Ipswich Chest Service rhe successful discovery of the source of tuberculous infection by single or repeated-tuberculin-testing of adults (Gedde-Dahl, 1952) and schoolchildren (Tatters-alL 1952; MacDougall et al., 1953; Davies, 1955) has been reported. Persistent attempts over the last six years to repeat this technique in Ipswich and East Suffolk resulted in the tracing of the source of infection in about a fifth of the children tuberculin-positive at their first test, and in a third of those converting their tuberculin test (van Zwanenberg, 1960). It was suspected that much of the infection unaccounted for might be due to milk infection with the bovine type of Mycobacterium tuberculosis. In such circumstances a simple method of comparative tuberculin-testing as is used by veterinary surgeons to determine the type of mycobacterial infection in cattle would be of great value. Testing simultaneously with avian and mammalian tuberculin they are able to differentiate virulent mycobacterial infection from tuberculin hypersensitivity due to other causes (Francis, 1958). In his report on the preparation of Weybridge P.P.D., Green-(1946) showed that guinea-pigs hypersensitized to different strains of Mycobacterium gave the largest reactions to the homologous P.P.D. tuberculin. Until recently there have been very few reports on comparative tuberculin-testing of human subjects. Avian and human tuberculin have been used by Edwards et al. (1953) and by Kuper (1958) in an attempt to-differentiate between-hypersensitivity due to virulent Myco. tuberctalosis and " non-tuberculous" hypersensitivity. The work of Enell (1955) and Lorber (1957)
American journal of infection control, 2006
Background: The usefulness of the 2-step tuberculin skin test as a tool for monitoring tuberculosis exposure among health care workers is controversial. Objectives: We aimed to determine the cost-effectiveness and influence of initiation of a preemployment, 2-step tuberculin skintesting program on the annual tuberculin skin conversion rate among a university hospital's health care workers. Methods: The tuberculin skin test conversion rates among the recipients of 31,729 tuberculin skin tests over 10 years were retrospectively analyzed. Data from the first 6 years of this study were generated when a single preemployment tuberculin skin test was utilized. Data from the last 4 years were gathered after the advent of a preemployment 2-step program. A cost analysis of the 2-step tuberculin skin test process was performed to determine the annual cost of this program. Results: Relative risk of a conversion was 8.43 times less during the 2-step period when compared with the years when a single tuberculin skin test was given at the start of employment (P , .001). A cost analysis showed that the annual added cost of the 2-step program was approximately $9565. Conclusion: A greater than 8-fold reduction in the number of annual tuberculin skin test conversion coincided with, but could not be attributed solely to, the initiation of a 2-step program in our hospital. The Infection Control Committee concluded that the 2-step testing program is essential to achieve the hospital's goal of a 0% annual tuberculin skin test conversion rate and that the annual cost is justified. (Am J Infect Control 2006;34:358-61.)
Journal of Medical Primatology, 2019
Background: Nowadays, several test methods with different useful values are available for diagnosis of the tuberculosis (TB) in non-human primates (NHPs). Despite some limitations of tuberculin skin test (TST), it is still the most commonly used method for TB testing of NHPs. Methods: During this investigation, TST was performed upon three groups of experimentally tuberculin sensitized and one group of non-sensitized vervet monkeys (Chlorocebus pygerythrus) by means of two types of old tuberculin (OT) and two types of purified protein derivative (PPD) tuberculin. Results: The data obtained from this study revealed that PPD tuberculin prepared from both Mycobacterium tuberculosis and Mycobacterium bovis has more advantages over OT in tuberculin testing of the vervet monkeys. The potency of the PPD tuberculin prepared from M bovis was estimated almost twice as much of the M tuberculosis. Conclusions: Intrapalpebral injection of 0.1 mL of a concentration of ≥1 mg/mL of PPD tuberculin prepared from M bovis is the preferred method for TST of vervet monkeys. K E Y W O R D S sensitization, tuberculin skin test (TST), tuberculosis, vervet monkey How to cite this article: Hablolvarid MH, Eslampanah M, Mosavari N, Baradaran-Seyed Z. Evaluation of tuberculin skin test (TST) in vervet monkeys (Chlorocebus pygerythrus) using experimentally tuberculin sensitized animals.