Prevalence of Tuberculosis Infection and Comparison of Multiple-puncture Liquid Tuberculin Test and Mantoux Test Among Drug Users

Background:Patients with rheumatic diseases (RD) are at higher risk of latent tuberculosis infection (LTBI) reactivation. To detect and treat it before starting treatment, especially with biological therapies, decrease the reactivation risk. Diagnosis is carried out by the tuberculin skin test (TST) or interferon-gamma release assays (IGRAs), IGRAs might be more specific and sensitive.Objectives:We aim to analyze the concordance between QuantiFERON-TB Gold In-Tube (QTF) and TST for the diagnosis of LTBI in patients with rheumatic diseases.Methods:A retrospective observational study was conducted including patients diagnosed with RD screened for LTBI with both TST and QTF (2014-2018). Demographical and clinical variables at screening and at follow-up were collected. The concordance between both tests has been estimated as categorical variables using Cohen´s Kappa test, considering “poor” if it is ≤ 0,20; “low” if 0,20 < k ≤ 0,40, “moderate” if 0,40 < k ≤ 0,60, “substantial” if 0,60 < k ≤ 0,80 and “optimal” if k > 0,80.Results:167 patients were included (57% women) with a mean age of 52±16 years. 42% of them had systemic autoimmune diseases, 22% spondyloarthropathies and 36% other RD. 2 had history of past active tuberculosis (TB). At the time of screening, 46.11% were treated with GC.LTBI was diagnosed in 35 patients: 15 had both QTF and TST positive, 16 only QTF positive and 4 only TST positive. 12 from 31 QTF positive patients were treated with GC at the time of screening. 3 from 19 TST positive patients were treated with GC at the time of screening.After LTBI screening 62 patients received biological treatment, 4 of them had both test positive, 6 only QTF positive and 2 only TST positive. 11 received LTBI treatment according to the hospital protocol (isoniazid for 6 to 9 months). 10 completed treatment, 1 did not because of intolerance and did not receive other treatment. 1 patient with only TST positive was considered a false positive and did not receive treatment. During follow-up no TB reactivation was reported.23 patients with LBTI received treatment other than biological therapy during follow-up, of them 8 received LBTI treatment. There was no TB reactivation during follow up.The Kappa concordance between QTF and TST was estimated: moderated in the whole sample, poor in the patients treated with GC at screening, and substantial when the patients treated with GC at screening were excluded. Results are shown in Table 1.Table 1.Kappa concordance between QTF and TST.Conclusion:QTF seems to be the most appropriate LTBI screening test in patients with RD treated with GC. Screening and treatment of LTBI in patients with RD treated with or without biological agents was effective in reducing TB reactivation.Disclosure of Interests:None declared.

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POSSIBILITIES OF A LABORATORY TEST BASED ON THE DETERMINATION OF THE T-CELL RESPONSE TO STIMULATION WITH SPECIFIC CFP10 AND ESAT6 ANTIGENS IN THE DETECTION OF TUBERCULOSIS INFECTION IN CHILDREN AND ADOLESCENTS

PEDIATRIA Journal named after G N SPERANSKY ◽

10.24110/0031-403x-2021-100-4-128-132 ◽

2021 ◽

Vol 100 (4) ◽

pp. 128-132

Author(s):

R.H. Fatykhova ◽

◽

L.А. Bаryshnikovа ◽

D.A. Kudlay ◽

A.P. Alekseev ◽

...

Keyword(s):

Laboratory Test ◽

Children And Adolescents ◽

Retrospective Cohort ◽

T Cell Response ◽

Tuberculosis Infection ◽

Mantoux Test ◽

History Of ◽

Positive Results ◽

Reverse Development

Objective of the study: to explore the possibilities of T-SPOT.TB testing to detect tuberculosis infection (TI) in children and adolescents. Materials and methods of research: the design – a multicenter retrospective cohort noncomparative uncontrolled study. The results of examination of children aged 1 to 17 years using the T-SPOT.TB test (n=1565): 774 boys (49,5%), 791 girls (50,5%). The median age of children is 8 [5; 13] years. Results: the rate of positive T-SPOT.TB tests was 7,2% (n=113). Further examination and in-depth examination of children with positive results (n=28), in every 4th case, a history of contact with a tuberculosis (TB) patient was established, every 4th child had previously been under treatment with phthisiatrician. The coincidence of positive results of the T-SPOT.TB test with the Mantoux test – in 87%, with the test with a recombinant tuberculosis allergen – in 100% of cases. Local TB in the phase of reverse development was detected in one child (4%), active TB – in 2 (7%). Conclusion: the T-SPOT.TB test is an alternative method for screening children for TI.

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Evaluation of effectiveness of mass screening for tuberculosis infection in children from 1 to 7 years old in Moscow

Tuberculosis and lung diseases ◽

10.21292/2075-1230-2021-99-12-14-21 ◽

2022 ◽

Vol 99 (12) ◽

pp. 14-21

Author(s):

L. V. Slogotskaya ◽

E. M. Bogorodskaya ◽

L. F. Shamuratova ◽

T. A. Sevostyanova

Keyword(s):

Health Care ◽

Primary Health Care ◽

Skin Test ◽

Positive Reaction ◽

Mass Screening ◽

Preventive Therapy ◽

Tuberculosis Infection ◽

Mantoux Test ◽

Primary Health

The objective: to evaluate effectiveness of mass screening for tuberculosis infection in children aged 1 to 7 years in different periods – before and after the use of tuberculosis recombinant allergen skin test (TRA) in primary health care as an additional diagnostic method.Subjects and Methods. The study was designed as continuous observational prospective-retrospective study. Two different periods were assessed: the first one was 2014-2016 when screening for tuberculosis infection was performed in all children from 1 to 17 years (inclusive) using Mantoux test with 2 TU PPD-L in pediatric primary health care, and then children suspected to have a positive reaction were referred to TB dispensary where they were examined with a skin test with TRA if necessary. The second period was from 2018 to 2020 when children of 1-7 years old were given Mantoux test and if tuberculosis infection was suspected, a skin test with TRA was done both in primary health care network and TB units. In the first 3 years, 1,864,137 children were examined and in the second 3 years, 2,078,800 children from 1 to 7 years old were examined.Results. Among children of 1-7 years old who were screened by two stages (initial Mantoux test, and then in those who had a positive reaction, the TRA test was used), only 10-12% of those referred to a phthisiologist were subject to dispensary follow-up. Thus, with the implementation of the new edict on screening for tuberculosis infection in children with two tests, this proportion has not changed compared to previous years, when screening was carried out only with one Mantoux test. The reason why almost 90% of the children who were referred to TB Dispensary were not subject to dispensary follow-up is the following: children who have had previous conversion of tuberculin tests, along with everyone else are again screened with Mantoux test despite being previously followed up by TB dispensary due to the primary infection.Recommendations:Currently, there is no division of Group VI into Subgroups A, B, C in the dispensary follow up grouping. Why should conversion of Mantoux test reaction from negative into positive not be considered an infection, and the increase in the reaction must be at least 6 mm.Since Order No. 124n of the Russian Ministry of Health allows testing with TRA in the primary health care in case of suspected infection, it is advisable to refer those who have already had this test to a phthisiologist.A child with conversion of Mantoux test should not be re-screened with Mantoux test but the TRA test should be used. If a positive reaction to the TRA test occurs for the first time, it should be considered as conversion of this test, and in this case the child should be examined by computed tomography (CT), and preventive therapy should be prescribed. If in subsequent years the TRA reaction increases by at least 6 mm after previous preventive therapy, the child should be re-referred for CT to rule out the development of active tuberculosis.

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Recombinant in vitro test T-SPOT.TB as a screening method for early diagnosis of tuberculosis infection

Tuberculosis and lung diseases ◽

10.21292/2075-1230-2020-98-4-48-52 ◽

2020 ◽

Vol 98 (4) ◽

pp. 48-52

Author(s):

E. P. Eremenko ◽

E. A. Borodulina ◽

I. A. Sergeeva ◽

D. A. Kudlay ◽

B. E. Borodulin

Keyword(s):

Screening Method ◽

Latent Tuberculosis ◽

Tuberculosis Infection ◽

Mantoux Test ◽

Skin Tests ◽

In Vitro Tests ◽

In Vitro Test ◽

Healthy Children ◽

Vitro Test

In addition to standard skin tests (Mantoux test with 2 TU PPD-L and diaskintest) for the diagnosis of tuberculosis infection, in vitro tests are used. One of these tests is T-SPOT.TB being more widely used in recent years.The objective: to evaluate the effectiveness of T-SPOT.TB test for early detection of tuberculosis infection in children and adolescents in Samara Region.Subjects and methods. From 2016 to 2019, results of T-SPOT.TB tests performed in 596 children aged 2 to 17 years inclusive were analyzed; those children had no immunodiagnosis of tuberculosis infection using skin tests since their parents refused to have it.Results. It was found out that the major reason for refusing skin tests was the “fear” of visiting a TB dispensary if the result had been positive — 38.43% (n = 229). The latent tuberculosis infection according to the results of T-SPOT.TB among children with concomitant pathology made 2.6%, among healthy children – 0.7%.Conclusion. T-SPOT.TB test may be used as an alternative method for diagnosis of tuberculosis infection, should the parent refuse to have skin tests. In children with concomitant pathology, T-SPOT.TB test can serve as a leading method for immunodiagnosis of tuberculosis.The authors state that they have no conflict of interests.

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SKIN TESTING WITH LIQUID OLD TUBERCULIN WITH A MULTIPLE PUNCTURE TECHNIQUE

PEDIATRICS ◽

10.1542/peds.42.3.465 ◽

1968 ◽

Vol 42 (3) ◽

pp. 465-470

Author(s):

Harvey Kravitz ◽

Fredric Burg ◽

Robert B. Lawson

Keyword(s):

Skin Testing ◽

Mantoux Test ◽

Multiple Point ◽

Plastic Ring ◽

Multiple Points ◽

Point Test ◽

Tuberculin Testing ◽

High Degree ◽

Multiple Puncture ◽

Puncture Technique

An improved multiple puncture technique (MPT) for tuberculin testing is applied with a nine-pointed plastic ring covered by a tube containing a specially concentrated liquid tuberculin. A high degree of positive and negative agreement was obtained with this test when compared to the Mantoux test (PPD, 5 TU). The reactions from the multiple puncture technique are discrete, single, and circular, and they are easy to read and measure. Erythema and induration from this test are smaller than from the Mantoux test (PPD, 5 TU). Children appear to show less fear and felt less pain with the multiple point test than with the Mantoux test. "Wet" tuberculin on multiple points eliminates two possible variables associated with "dry" tuberculin on the points–the length of time that the tines are held in the skin and the moisture content of the skin.

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Latent tuberculosis infection and tuberculosis in children and adolescents

Einstein (São Paulo) ◽

10.1590/s1679-45082018ao4090 ◽

2018 ◽

Vol 16 (3) ◽

Author(s):

Cassia Satsuki Ishikawa ◽

Olivia Mari Matsuo ◽

Flavio Sarno

Keyword(s):

Computed Tomography ◽

Latent Tuberculosis Infection ◽

Latent Tuberculosis ◽

Tuberculin Test ◽

Tuberculosis Infection ◽

Gastric Aspirate ◽

X Ray ◽

Qualitative Variables ◽

Chest X Ray ◽

Tuberculosis In Children

ABSTRACT Objective: To describe the characteristics of patients diagnosed with tuberculosis and latent tuberculosis infection. Methods: A retrospective study, between 2012 and 2015, with data from patients of Programa Einstein na Comunidade de Paraisópolis. To evaluate possible factors associated with patient's sex and diagnoses of tuberculosis and latent tuberculosis infection, χ2 or Fisher's exact tests were used for qualitative variables, and Mann-Whitney test for quantitative or ordinal qualitative variables. Results: A total of 77 patients were evaluated. Age ranged from 6 months to 13.4 years, with a majority of males (54.5%), aged zero to 4 years (54.5%), diagnosed with latent tuberculosis infection (64.9%), and classified as eutrophic (71.2%). The tuberculin test was positive in 92% and in most cases the values were above 10mm (68.0%). Approximately three-quarters of chest X-ray tests were normal (72.7%). After chest X-ray, computed tomography of thorax was the most ordered exam (29.9%), followed by smear and culture for Mycobacterium tuberculosis in the gastric aspirate (28.6%). The frequencies of altered chest X-ray (70.4% versus 4.0%), computed tomography of thorax requests (55.6% versus 16.0%) and other tests requested (81.5% versus 38.0%) were significantly higher in patients with a diagnosis of tuberculosis, relative to those with latent tuberculosis infection, respectively. Conclusion: In our sample, proportions of altered chest X-ray, and performing computed tomography of thorax and other tests in patients diagnosed with tuberculosis were higher than in those with latent tuberculosis infection.

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