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Journal of Ayub Medical College,... 2020Tuberculosis 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... (Comparative Study)
Comparative Study
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.
Topics: Child; Humans; Mycobacterium bovis; Pakistan; Skin Tests; Tuberculin Test; Tuberculosis
PubMed: 32583995
DOI: No ID Found -
Emerging Infectious Diseases Sep 2022In 2015, Australia updated premigration screening for tuberculosis (TB) disease in children 2-10 years of age to include testing for infection with Mycobacterium...
In 2015, Australia updated premigration screening for tuberculosis (TB) disease in children 2-10 years of age to include testing for infection with Mycobacterium tuberculosis and enable detection of latent TB infection (LTBI). We analyzed TB screening results in children <15 years of age during November 2015-June 2017. We found 45,060 child applicants were tested with interferon-gamma release assay (IGRA) (57.7% of tests) or tuberculin skin test (TST) (42.3% of tests). A total of 21 cases of TB were diagnosed: 4 without IGRA or TST, 10 with positive IGRA or TST, and 7 with negative results. LTBI was detected in 3.3% (1,473/44,709) of children, for 30 applicants screened per LTBI case detected. LTBI-associated factors included increasing age, TB contact, origin from a higher TB prevalence region, and testing by TST. Detection of TB and LTBI benefit children, but the updated screening program's effect on TB in Australia is likely to be limited.
Topics: Australia; Child; Humans; Interferon-gamma Release Tests; Latent Tuberculosis; Mass Screening; Mycobacterium tuberculosis; Tuberculin Test
PubMed: 35997353
DOI: 10.3201/eid2809.212426 -
Thorax Feb 2005
Topics: Adolescent; BCG Vaccine; Child; Hong Kong; Humans; Tuberculin Test; Tuberculosis; United Kingdom
PubMed: 15681490
DOI: 10.1136/thx.2004.028746 -
Tropical Animal Health and Production Apr 2021Tuberculosis (TB) is a zoonotic disease primarily caused by pathogens belonging to the genus of Mycobacterium. Programs of control and eradication for bovine TB include...
Tuberculosis (TB) is a zoonotic disease primarily caused by pathogens belonging to the genus of Mycobacterium. Programs of control and eradication for bovine TB include a screening using single intradermal tuberculin (SIT) test with Mycobacterium bovis (M. bovis)-purified protein derivatives (PPD-B) single or concurrent with Mycobacterium avium (M. avium)-purified protein derivatives (PPD-A). This study aimed to determine the effects of intradermal PPD-B and PPD-A test on immune-related mRNA and microRNAs in dermal oedema exudates of water buffaloes (Bubalus bubalis). The investigation was carried out on RNA extracted from dermal oedema exudates of 36 animals, of which 24 were M. bovis positive (M. bovis+) and 12 M. avium positive (M. avium+). The lymphocyte polarization toward Th1, Th2, TReg, and Th17 lineages was addressed by measuring the abundance of the respective cytokines and transcription factors, namely TBET, STAT4, IFNγ, and IL1β for Th1; STAT5B, and IL4 for Th2; FOXP3 and IL10 for TReg; and RORC, STAT3, and IL17A for Th17. Due to the very low abundance of Th17-related genes, a digital PCR protocol was also applied. The abundance of microRNAs involved in the immune response against PPDs, including miR-122-5p, miR-148a-3p, miR30a, and miR-455-5p, was equally measured. Results showed that IFNγ (fold change = 2.54; p = 0.037) and miR-148a-3p (fold change = 2.54; p = 0.03) were upregulated in M. bovis+ as compared to M. avium+ samples. Our preliminary results supported the pivotal role of IFNγ in the local immune response related to PPD-B and highlighted the differential expression of miR-148a-3p, which downregulates the proinflammatory cytokines and the TLR4-mediated NF-κB activation, providing an anti-inflammation modulator in responses to mycobacterial infection.
Topics: Animals; Buffaloes; Cattle; Cattle Diseases; Edema; Exudates and Transudates; MicroRNAs; Mycobacterium bovis; RNA, Messenger; Tuberculin; Tuberculin Test; Tuberculosis, Bovine
PubMed: 33825069
DOI: 10.1007/s11250-021-02696-1 -
Scientific Reports Feb 2023Bovine tuberculosis is a contagious bacterial disease of worldwide economic, zoonotic and welfare importance caused mainly by Mycobacterium bovis infection. Current...
Bovine tuberculosis is a contagious bacterial disease of worldwide economic, zoonotic and welfare importance caused mainly by Mycobacterium bovis infection. Current regulatory diagnostic methods lack sensitivity and require improvement. We have developed a multiplex serological test for bovine tuberculosis and here we provide an estimate of the diagnostic accuracy of the test in cattle. Positive and negative reference serum samples were obtained from animals from Europe and the United States of America. The diagnostic specificity estimate was 98.4% and 99.7% using high sensitivity and high specificity settings of the test respectively. Tuberculin boosting did not affect the overall specificity estimate. The diagnostic sensitivity in samples from Mycobacterium bovis culture positive animals following tuberculin boosting was 93.9%.The relative sensitivity following boosting in tuberculin test positive, lesion positive animals and interferon gamma test positive, lesion positive animals was 97.2% and 96.9% respectively. In tuberculin test negative, lesion positive animals and in interferon gamma test negative, lesion positive animals, the relative sensitivity following tuberculin boosting was 88.2% and 83.6% respectively. The results show that the test has high diagnostic sensitivity and specificity and can detect infected animals that are missed by tuberculin and interferon gamma testing.
Topics: Animals; Cattle; Tuberculosis, Bovine; Tuberculin; Interferon-gamma; Mycobacterium bovis; Tuberculin Test; Sensitivity and Specificity
PubMed: 36726018
DOI: 10.1038/s41598-023-28410-9 -
BMC Infectious Diseases Oct 2016Tuberculosis (TB) disproportionately affects immigrants, HIV-infected individuals, and those living in crowded settings such as homeless shelters and correctional... (Comparative Study)
Comparative Study
BACKGROUND
Tuberculosis (TB) disproportionately affects immigrants, HIV-infected individuals, and those living in crowded settings such as homeless shelters and correctional facilities. Although the majority of jails and prisons use a tuberculin skin test (TST) for latent tuberculosis infection (LTBI) screening, limited data exist on the clinical performance and costs of the TST compared to interferon gamma release assays (IGRAs) in this setting.
METHODS
A prospective pilot study comparing cost between TST and an IGRA (QuantiFERON Gold In-tube, QFT-GIT) for the detection of LTBI in a convenience sample of inmates entering the Dallas County Jail (DCJ) was conducted June-October 2014. Participants completed a risk questionnaire, TST placement, QFT-GIT testing, and were offered opt-out HIV-Ab testing. LTBI prevalence based on TST and QFT-GIT results, an evaluation of discordant results and a cost analysis are presented.
RESULTS
A total of 529 subjects were enrolled. The majority were male (75 %), and 46 % were Black, 29 % White, and 24 % Hispanic. Most (85 %) had been previously incarcerated. Over 28 % of participants were released prior to TST reading, with paired QFT-GIT and TST results available for 351 subjects. Of these, nine (2.6 %) tested positive by TST and 47 (13.4 %) tested positive by QFT-GIT. It costs $23.27 more per inmate per year to screen with QFT-GIT than TST in this population, though the cost per LTBI case detected was nearly three times higher for TST than QFT-GIT ($1247 v $460).
CONCLUSIONS
We found a substantially higher rate of QFT-GIT positivity compared to TST in this sample of individuals entering the Dallas County Jail. Although no gold standard exists, this finding may indicate under-recognized LTBI in this setting. QFT-GIT as an initial screening tool was more time-efficient, had four-fold fewer labor costs and provided results on more individuals when compared with the TST. The overall cost of QFT-GIT was $23.27 more per inmate per year, though the cost per LTBI case detected was nearly three times higher for TST than QFT-GIT. Further research is needed to determine the long-term performance of IGRA testing in the correctional setting and the public health implications of pairing QFT-GIT screening with other tests for communicable diseases.
Topics: Adolescent; Adult; Costs and Cost Analysis; Female; Humans; Interferon-gamma Release Tests; Male; Middle Aged; Mycobacterium tuberculosis; Pilot Projects; Prevalence; Prisoners; Prisons; Prospective Studies; Texas; Tuberculin Test; Tuberculosis, Pulmonary; Young Adult
PubMed: 27733123
DOI: 10.1186/s12879-016-1901-8 -
British Medical Journal May 1979
Topics: Humans; Methods; Tuberculin Test; Tuberculosis
PubMed: 445041
DOI: No ID Found -
PloS One 2019The goal of this study was to perform a cost-effectiveness analysis from the public health system perspective, comparing five strategies for Latent Tuberculosis...
Cost-effectiveness of QuantiFERON-TB Gold In-Tube versus tuberculin skin test for diagnosis and treatment of Latent Tuberculosis Infection in primary health care workers in Brazil.
OBJECTIVES
The goal of this study was to perform a cost-effectiveness analysis from the public health system perspective, comparing five strategies for Latent Tuberculosis Infection (LTBI) diagnosis in primary health care workers in Brazil.
DESIGN
Analytical model for decision making, characterized by cost-effectiveness analysis.
SETTING
Primary Care Level, considering primary health care workers in Brazil.
PARTICIPANTS
An analytical model for decision making, characterized by a tree of probabilities of events, was developed considering a hypothetical cohort of 10,000 primary health care workers, using the software TreeAge Pro™ 2013 to simulate the clinical and economic impacts of new diagnostic technology (QuantiFERON®-TB Gold in-Tube) versus the traditional tuberculin skin test.
METHODS
This model simulated five diagnostic strategies for LTBI in primary health care workers (HCW) in Brazil: tuberculin skin testing using ≥5 mm cut-off, tuberculin skin testing ≥10 mm cut-off, QuantiFERON®-TB Gold in-Tube, tuberculin skin testing using ≥5 mm cut-off confirmed by QuantiFERON®-TB Gold In-Tube if TST positive, tuberculin skin testing using ≥10 mm cut-off confirmed by QuantiFERON®-TB Gold In-Tube if TST positive.
PRIMARY AND SECONDARY OUTCOME MEASURES
The outcome measures are the number of individuals correctly classified by the test and the number of Tuberculosis cases avoided.
RESULTS
The most cost-effective strategy was the tuberculin skin test considering ≥10mm cut-off. The isolated use of the QuantiFERON®-TB Gold In-Tube revealed the strategy of lower efficiency with incremental cost-effectiveness ratio (ICER) of US$ 146.05 for each HCW correctly classified by the test.
CONCLUSIONS
The tuberculin skin test using ≥10 mm cut-off was the most cost-effective strategy in the diagnosis of Latent Tuberculosis Infection in primary health care works in Brazil.
Topics: Adult; Aged; Clinical Decision-Making; Cost-Benefit Analysis; Decision Trees; Female; Health Personnel; Humans; Latent Tuberculosis; Male; Mass Screening; Middle Aged; Primary Health Care; Reproducibility of Results; Sensitivity and Specificity; Tuberculin Test; Young Adult
PubMed: 31725786
DOI: 10.1371/journal.pone.0225197 -
Canadian Family Physician Medecin de... Jun 1995Interpreting and acting upon results of the tuberculin skin test (Mantoux test) can be confusing because the test is inherently ambiguous and published recommendations... (Review)
Review
Interpreting and acting upon results of the tuberculin skin test (Mantoux test) can be confusing because the test is inherently ambiguous and published recommendations for investigation and prevention of tuberculosis are complex. This article presents a step-by-step guide to enable family physicians to make effective use of the Mantoux test.
Topics: Clinical Protocols; Family Practice; Humans; Isoniazid; Tuberculin Test; Tuberculosis, Pulmonary
PubMed: 7780314
DOI: No ID Found -
BMC Veterinary Research Mar 2021Bovine tuberculosis (bTB), is a worldwide disease caused by Mycobacterium bovis (M. bovis). The success of bTB eradication and control programs is based on early...
BACKGROUND
Bovine tuberculosis (bTB), is a worldwide disease caused by Mycobacterium bovis (M. bovis). The success of bTB eradication and control programs is based on early detection and the removal of reactors from a herd thus routine testing and cull strategy have been applied globally. Since the late nineteenth century, the Tuberculin Skin Test (TST) has been the primary antemortem test available to support bTB eradication campaigns. Due to the TST limitations in terms of Se and Sp, the credibility of the diagnosis is frequently questioned given the occurrence of false-positive and false-negative reactions, therefore, it is necessary to confirm reactive animals using other methods, ensuring the reliability of the diagnosis. The aim of this study was to evaluate the sensitivity and specificity of a multiplex enzyme-linked immunosorbent assay (ELISA) relative to the tuberculin test used for the diagnosis of tuberculosis in cattle in Brazil.
RESULTS
Lack of agreement between comparative cervical tuberculin test and ELISA IDEXX TM was observed. The 2 animals positive on the comparative cervical tuberculin test did not react at the ELISA IDEXX TM and 22 negative reactors by comparative cervical tuberculin test were positive by the ELISA IDEXX TM. The ELISA IDEXX TM showed sensitivity that is significantly lower than the official screening test the single cervical tuberculin. ELISA IDEXX TM also detected infected animals and herds undetected by the comparative cervical tuberculin test. The parallel use of comparative cervical tuberculin test and ELISA IDEXX TM increased sensitivity and the feasibility bTB screening.
CONCLUSIONS
The results obtained here suggest that the ELISA IDEXX TM may be a supplemental test for the detection of Mycobacterium bovis infection in regions without routine testing and slaughter, where the disease generally progresses to more advanced stages and antibody responses are likely to be more prevalent. Evidence to support the validation of the ELISA IDEXX™ as a supplemental test for bTB eradication programs was provided.
Topics: Animals; Brazil; Cattle; Enzyme-Linked Immunosorbent Assay; Mycobacterium bovis; Sensitivity and Specificity; Tuberculin Test; Tuberculosis, Bovine
PubMed: 33789652
DOI: 10.1186/s12917-021-02839-4