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Journal of Preventive Medicine and... Mar 2017Tuberculosis (TB) is a contagious, infectious disease, due to Mycobacterium tuberculosis (MT) that has always been a permanent challenge over the course of human... (Review)
Review
Tuberculosis (TB) is a contagious, infectious disease, due to Mycobacterium tuberculosis (MT) that has always been a permanent challenge over the course of human history, because of its severe social implications. It has been hypothesized that the genus Mycobacterium originated more than 150 million years ago. In the Middle Ages, scrofula, a disease affecting cervical lymph nodes, was described as a new clinical form of TB. The illness was known in England and France as "king's evil", and it was widely believed that persons affected could heal after a royal touch. In 1720, for the first time, the infectious origin of TB was conjectured by the English physician Benjamin Marten, while the first successful remedy against TB was the introduction of the sanatorium cure. The famous scientist Robert Koch was able to isolate the tubercle bacillus and presented this extraordinary result to the society of Physiology in Berlin on 24 March 1882. In the decades following this discovery, the Pirquet and Mantoux tuberculin skin tests, Albert Calmette and Camille Guérin BCG vaccine, Selman Waksman streptomycin and other anti-tuberculous drugs were developed.
Topics: Antitubercular Agents; History, 18th Century; History, 19th Century; History, 20th Century; History, 21st Century; Humans; Mycobacterium tuberculosis; Tuberculin Test; Tuberculosis
PubMed: 28515626
DOI: No ID Found -
BMC Infectious Diseases Mar 2017Timely and accurate identification of people with latent tuberculosis infection (LTBI) is important for controlling Mycobacterium tuberculosis (TB). There is no gold... (Comparative Study)
Comparative Study Meta-Analysis Review
Comparing interferon-gamma release assays with tuberculin skin test for identifying latent tuberculosis infection that progresses to active tuberculosis: systematic review and meta-analysis.
BACKGROUND
Timely and accurate identification of people with latent tuberculosis infection (LTBI) is important for controlling Mycobacterium tuberculosis (TB). There is no gold standard for diagnosis of LTBI. Screening tests such as interferon gamma release assays (IGRAs) and tuberculin skin test (TST) provide indirect and imperfect information. This systematic review compared two types of IGRAs QuantiFERON®-TB Gold In-Tube test (QFT-GIT) and T-SPOT.TB with TST for identification of LTBI by predicting progression to a diagnosis of active TB in three subgroups: children, immunocompromised people, and those recently arrived from countries with high TB burden.
METHODS
Cohort studies were eligible for inclusion. We searched MEDLINE, EMBASE, the Cochrane Library and other databases from December 2009 to June 2015. One reviewer screened studies, extracted data, and assessed risk of bias with cross checking by a second reviewer. Strength of association between test results and incidence of TB was summarised using cumulative incidence ratios (CIRs with 95% CIs). Summary effect measures: the ratio of CIRs (R-CIR) with 95% CIs. R-CIRs, were pooled using a random-effects model. Heterogeneity was assessed using Chi-squared and I statistics.
RESULTS
Seventeen studies, mostly of moderate or high risk of bias (five in children, 10 in immunocompromised people, and two in those recently arrived) were included. In children, while in two studies, there was no significant difference between QFT-GIT and TST (≥5 mm) (pooled R-CIR = 1.11, 95% CI: 0.71, 1.74), two other studies showed QFT-GIT to outperform TST (≥10 mm) in identifying LTBI. In immunocompromised people, IGRA (T-SPOT.TB) was not significant different from TST (≥10 mm) for identifying LTBI, (pooled R-CIR = 1.01, 95% CI: 0.65, 1.58). The forest plot of two studies in recently arrived people from countries with high TB burden demonstrated inconsistent findings (high heterogeneity; I = 92%).
CONCLUSIONS
Prospective studies comparing IGRA testing against TST on the progression from LTBI to TB were sparse, and these results should be interpreted with caution due to uncertainty, risk of bias, and unexplained heterogeneity. Population-based studies with adequate sample size and follow-up are required to adequately compare the performance of IGRA with TST in people at high risk of TB.
Topics: Adult; Child; Disease Progression; Humans; Immunocompromised Host; Incidence; Interferon-gamma Release Tests; Latent Tuberculosis; Tuberculin Test
PubMed: 28274215
DOI: 10.1186/s12879-017-2301-4 -
Tuberculosis (Edinburgh, Scotland) May 2023Tuberculosis has remained a global concern for public health affecting the lives of people for ages. Approximately 10 million people are affected by the disease and 1.5... (Review)
Review
Tuberculosis has remained a global concern for public health affecting the lives of people for ages. Approximately 10 million people are affected by the disease and 1.5 million succumb to the disease worldwide annually. The COVID-19 pandemic has highlighted the role of early diagnosis to win the battle against such infectious diseases. Thus, advancement in the diagnostic approaches to provide early detection forms the foundation to eradicate and manage contagious diseases like tuberculosis. The conventional diagnostic strategies include microscopic examination, chest X-ray and tuberculin skin test. The limitations associated with sensitivity and specificity of these tests demands for exploring new techniques like probe-based assays, CRISPR-Cas and microRNA detection. The aim of the current review is to envisage the correlation between both the conventional and the newer approaches to enhance the specificity and sensitivity. A significant emphasis has been placed upon nanodiagnostic approaches manipulating quantum dots, magnetic nanoparticles, and biosensors for accurate diagnosis of latent, active and drug-resistant TB. Additionally, we would like to ponder upon a reliable method that is cost-effective, reproducible, require minimal infrastructure and provide point-of-care to the patients.
Topics: Humans; Mycobacterium tuberculosis; Pandemics; COVID-19; Tuberculosis; Tuberculin Test
PubMed: 37031646
DOI: 10.1016/j.tube.2023.102340 -
The Pediatric Infectious Disease Journal May 2023This review summarizes studies evaluating the performance of the QuantiFERON-TB Gold Plus (QFT-Plus) interferon-gamma release assay (IGRA) test for Mycobacterium... (Review)
Review
This review summarizes studies evaluating the performance of the QuantiFERON-TB Gold Plus (QFT-Plus) interferon-gamma release assay (IGRA) test for Mycobacterium tuberculosis ( Mtb ) infection in children. Literature searching was conducted using PubMed, MEDLINE and Embase (January 2017 to December 2021) and the terms "children" or "pediatric" and "IGRAs" or "QuantiFERON-TB Gold Plus." Selected studies (N = 14; 4646 subjects) enrolled children with Mtb infection, tuberculosis (TB) disease or healthy children with household TB contacts. Agreement between QFT-Plus and tuberculin skin test (TST) (kappa values) ranged from -0.201 (no agreement) to 0.83 (almost perfect agreement). Assay sensitivity of QFT-Plus (against reference standard of microbiologically confirmed TB disease) was 54.5%-87.3%, with no reported difference in children less than 5 versus greater than or equal to 5 years of age. In individuals less than or equal to 18 years of age, the rate of indeterminate results was 0%-33.3% (2.6% in children <2 years). IGRAs may overcome the limitations of TST in young, Bacillus Calmette-Guérin-vaccinated children.
Topics: Humans; Child, Preschool; Sensitivity and Specificity; Tuberculosis; Interferon-gamma Release Tests; Tuberculin Test; Mycobacterium tuberculosis; Latent Tuberculosis
PubMed: 36795574
DOI: 10.1097/INF.0000000000003877 -
Canadian Medical Association Journal Jan 1965A brief historical review of the tuberculin test is followed by consideration of the immunological factors concerned in the tuberculin reaction. The problems in the...
A brief historical review of the tuberculin test is followed by consideration of the immunological factors concerned in the tuberculin reaction. The problems in the interpretation of the test, the dosage and types of material used, and methods of administration are discussed. The current problem of tuberculin reversion with and without treatment, as exemplified by the current study of Halifax school children, is considered in some detail. The role of the tuberculin test in the present-day program of tuberculosis control is indicated.
Topics: Adolescent; BCG Vaccine; Canada; Child; England; Geriatrics; History; History, 19th Century; Humans; Infant; Infant, Newborn; Mycobacterium bovis; Tuberculin Test; Tuberculosis; United States; Vaccination; Wales
PubMed: 14216144
DOI: No ID Found -
JAMA Network Open May 2023
Topics: Humans; Latent Tuberculosis; Tuberculin Test; Mass Screening
PubMed: 37129898
DOI: 10.1001/jamanetworkopen.2023.12114 -
BMC Medicine Mar 2016The decision to treat active tuberculosis (TB) is dependent on microbiological tests for the organism or evidence of disease compatible with TB in people with a high... (Review)
Review
The decision to treat active tuberculosis (TB) is dependent on microbiological tests for the organism or evidence of disease compatible with TB in people with a high demographic risk of exposure. The tuberculin skin test and peripheral blood interferon-γ release assays do not distinguish active TB from a cleared or latent infection. Microbiological culture of mycobacteria is slow. Moreover, the sensitivities of culture and microscopy for acid-fast bacilli and nucleic acid detection by PCR are often compromised by difficulty in obtaining samples from the site of disease. Consequently, we need sensitive and rapid tests for easily obtained clinical samples, which can be deployed to assess patients exposed to TB, discriminate TB from other infectious, inflammatory or autoimmune diseases, and to identify subclinical TB in HIV-1 infected patients prior to commencing antiretroviral therapy. We discuss the evaluation of peripheral blood transcriptomics, proteomics and metabolomics to develop the next generation of rapid diagnostics for active TB. We catalogue the studies published to date seeking to discriminate active TB from healthy volunteers, patients with latent infection and those with other diseases. We identify the limitations of these studies and the barriers to their adoption in clinical practice. In so doing, we aim to develop a framework to guide our approach to discovery and development of diagnostic biomarkers for active TB.
Topics: Communicable Diseases; Female; Humans; Interferon-gamma Release Tests; Male; Microbiological Techniques; Mycobacterium; Tuberculin Test; Tuberculosis, Pulmonary
PubMed: 27005907
DOI: 10.1186/s12916-016-0583-9 -
Journal of Infection in Developing... Aug 2018Mantoux test aids in the diagnosis of tuberculosis (TB), however its application and interpretation are dependent on multiple factors. (Observational Study)
Observational Study
INTRODUCTION
Mantoux test aids in the diagnosis of tuberculosis (TB), however its application and interpretation are dependent on multiple factors.
METHODOLOGY
A prospective study enrolling 400 children (aged 2-12) suspected to have tuberculosis. All participants received Mantoux test with two different strengths (1 TU and 5 TU) of Purified Protein Derivative (PPD) on different forearms. The test was read by two readers after 48 ± 2 and 72 ± 2 hours. Primary outcome was difference in the size of induration when read by two readers (interobserver variability). Secondary outcomes were difference in the size of induration at different intervals, with different strengths of PPD and percentage positivity of Mantoux test in TB patients.
RESULTS
Statistically significant difference was seen in the size of induration when read by two different readers, with fair to moderate agreement when read at 48 and 72 hours (1 TU: p = 0.002, k = 0.52 and p = 0.1, k = 0.73 respectively, 5 TU: p = 0.001, k = 0.39 and p = 0.0009, k = 0.33 respectively). Tendency of under-reading occurred when size of induration was close to significant level (10-14 mm). Size of induration was similar when read at 48 or 72 hours (1 TU: p = 0.9, 5 TU: p = 1.0). Mantoux positivity rate in patients with TB was more with 5 TU as compared to 1 TU (61.2% vs. 16.3%).
CONCLUSIONS
There is significant interobserver variability with a tendency to under-read around the cutoff point. The use of 5 TU PPD at 48 hours by a trained physician can aid in early and more reliable diagnosis of TB.
Topics: BCG Vaccine; Child; Child, Preschool; Female; Humans; Male; Observer Variation; Prospective Studies; Tuberculin Test; Tuberculosis; Tuberculosis, Meningeal; Tuberculosis, Pulmonary
PubMed: 31958324
DOI: 10.3855/jidc.9601 -
Microbiology Spectrum Jan 2017For 2015, tuberculosis (TB) incidence in the United States has plateaued at 3.0 per 100,000. This remains the lowest case rate since recording started. On the global... (Review)
Review
For 2015, tuberculosis (TB) incidence in the United States has plateaued at 3.0 per 100,000. This remains the lowest case rate since recording started. On the global level, although the TB epidemic is larger than previously estimated, TB deaths and incidence rate continue to fall. For both low and high incidence countries, accelerating the decline in TB incidence towards elimination goals requires that more emphasis be placed on strengthening systems for detection and treatment of latent TB infection (LTBI) in addition to improving TB care globally. Here, we review the tuberculin skin test and gamma interferon release assays currently available for the detection of LTBI.
Topics: Diagnostic Tests, Routine; Humans; Interferon-gamma Release Tests; Latent Tuberculosis; Tuberculin Test
PubMed: 28185619
DOI: 10.1128/microbiolspec.TNMI7-0019-2016 -
Brazilian Journal of Microbiology :... Mar 2022Tuberculosis remains one of the most important infectious diseases with well-known zoonotic nature that affect humans, wildlife, and domestic animals, including goats....
Tuberculosis remains one of the most important infectious diseases with well-known zoonotic nature that affect humans, wildlife, and domestic animals, including goats. Nonetheless, no intradermal tuberculin test has been standardized for caprine diagnosis of tuberculosis. The present study investigated the intradermal comparative cervical tuberculin test (ICCTT) in the diagnosis of tuberculosis among 60 goats from farms with history of tuberculosis. The cutoff applied to goats was based on a study where goats had been experimentally infected with Mycobacterium bovis and Mycobacterium avium. Clinical examination, bacteriological culture, and histopathological staining were assessed to the diagnosis. Isolates compatible with mycobacteria were subjected for molecular diagnosis based on gyrB-restriction fragment length polymorphism (RFLP) analysis and PCR restriction-enzyme analysis (PRA) of hsp65 gene by BstEII and HaeIII, namely PRA-hsp65 assay. From all goats, 60% (n = 36/60), 3.3% (n = 2/60), and 36.7% (n = 22/60) showed positive, inconclusive, and negative reactions, respectively. Out of 36 goats with ICCTT positive, 75% (n = 27/36) had isolation of mycobacteria and were detected M. bovis by gyrB-RFLP. Molecular diagnosis and histopathological findings compatible with tuberculosis showed 86.1% (n = 31/36) concordance with the ICCTT. When compared ICCTT with M. bovis isolation, gyrB-RFLP, and histopathology, the better arithmetic means of sensitivity and specificity were 2.5 mm for ICCTT compared with M. bovis isolation and gyrB-RFLP, and 4.55 mm when compared with histopathology. Both receiver operating characteristic (ROC) curves presented statistical significance (P < 0.001). The identification of other mycobacteria, e.g., M. kansasii, M. flavescens, M. avium, M. florentinum, M. lentiflavum, M. simiae, and Corynebacterium pseudotuberculosis, not influenced positive results in ICCTT. The concordance between bacteriological, histopathological, and molecular identification with ICCTT findings indicate that the tuberculin test may be used as a valuable tool for diagnosis of caprine tuberculosis and reinforce the importance of association of methods to diagnostic of the disease from animal origin.
Topics: Animals; Goats; Mycobacterium bovis; Tuberculin; Tuberculin Test; Tuberculosis
PubMed: 34767242
DOI: 10.1007/s42770-021-00650-9