scholarly journals High Prevalence of Active and Latent Tuberculosis in Children and Adolescents in Tibetan Schools in India: The Zero TB Kids Initiative in Tibetan Refugee Children

2018 ◽  
Vol 69 (5) ◽  
pp. 760-768 ◽  
Author(s):  
Kunchok Dorjee ◽  
Sonam Topgyal ◽  
Chungdak Dorjee ◽  
Tenzin Tsundue ◽  
Tenzin Namdol ◽  
...  
Keyword(s):  
Skin Testing ◽  
Latent Tuberculosis ◽  
Population Level ◽  
Preventive Therapy ◽  
Case Finding ◽  
Refugee Children ◽  
Tuberculin Skin Testing ◽  
Tibetan Refugee ◽  
Tibetan Refugees ◽  
Tuberculosis In Children

Abstract Background Tuberculosis (TB) prevalence is high among Tibetan refugees in India, with almost half of cases occurring in congregate facilities, including schools. A comprehensive program of TB case finding and treatment of TB infection (TBI) was undertaken in schools for Tibetan refugee children. Methods Schoolchildren and staff in Tibetan schools in Himachal Pradesh, India, were screened for TB with an algorithm using symptoms, chest radiography, molecular diagnostics, and tuberculin skin testing. Individuals with active TB were treated and those with TBI were offered isoniazid-rifampicin preventive therapy for 3 months. Results From April 2017 to March 2018, we screened 5391 schoolchildren (median age, 13 years) and 786 staff in 11 Tibetan schools. Forty-six TB cases, including 1 with multidrug resistance, were found in schoolchildren, for a prevalence of 853 per 100 000. Extensively drug-resistant TB was diagnosed in 1 staff member. The majority of cases (66%) were subclinical. TBI was detected in 930 of 5234 (18%) schoolchildren and 334 of 634 (53%) staff who completed testing. Children in boarding schools had a higher prevalence of TBI than children in day schools (915/5020 [18%] vs 15/371 [4%]; P < .01). Preventive therapy was provided to 799 of 888 (90%) schoolchildren and 101 of 332 (30%) staff with TBI; 857 (95%) people successfully completed therapy. Conclusions TB prevalence is extremely high among Tibetan schoolchildren. Effective active case finding and a high uptake and completion of preventive therapy for children were achieved. With leadership and community mobilization, TB control is implementable on a population level.

scholarly journals Interferon-Gamma Release Assays versus Tuberculin Skin Testing for the Diagnosis of Latent Tuberculosis Infection: An Overview of the Evidence

2013 ◽  
Vol 2013 ◽  
pp. 1-11 ◽  
Author(s):  
A. Trajman ◽  
R. E. Steffen ◽  
D. Menzies
Keyword(s):  
Tuberculin Skin Test ◽  
Skin Test ◽  
Interferon Gamma ◽  
Clinical Evidence ◽  
Skin Testing ◽  
Latent Tuberculosis ◽  
Preventive Therapy ◽  
Tuberculin Skin Testing ◽  
Interferon Gamma Release Assays ◽  
Definition Of

A profusion of articles have been published on the accuracy and uses of interferon-gamma releasing assays. Here we review the clinical applications, advantages, and limitations of the tuberculin skin test and interferon-gamma release assays and provide an overview of the most recent systematic reviews conducted for different indications for the use of these tests. We conclude that both tests are accurate to detect latent tuberculosis, although interferon-gamma release assays have higher specificity than tuberculin skin testing in BCG-vaccinated populations, particularly if BCG is received after infancy. However, both tests perform poorly to predict risk for progression to active tuberculosis. Interferon-gamma release assays have significant limitations in serial testing because of spontaneous variability and lack of a validated definition of conversion and reversion, making it difficult for clinicians to interpret changes in category (conversions and reversions). So far, the most important clinical evidence, that is, that isoniazid preventive therapy reduces the risk for progression to disease, has been produced only in tuberculin skin test-positive individuals.

Apparent Resurgence of Tuberculosis in Urban Children

PEDIATRICS ◽  
1981 ◽  
Vol 68 (5) ◽  
pp. 647-649
Author(s):  
Laura S. Inselman ◽  
Nadia B. El-Maraghy ◽  
Hugh E. Evans
Keyword(s):  
New York ◽  
Skin Testing ◽  
Treatment Programs ◽  
Tuberculin Skin Testing ◽  
Purified Protein Derivative ◽  
City Community ◽  
Adequate Funding ◽  
Risk Areas ◽  
Tuberculosis In Children ◽  
The City

An apparent increase in incidence of pulmonary and extrapulmonary forms of tuberculosis was observed in children in an inner-city community in New York City. This occurred during years in which the case rates of tuberculosis declined in the city and the nation. Two unusual presentations of childhood tuberculosis are described. This experience suggests that physicians should be more aware of the diagnosis of tuberculosis in children and that routine tuberculin skin testing with 5 TU of purified protein derivative (PPD) should be continued, with emphasis on testing in high-risk areas. Adequate funding of detection and treatment programs may prevent reemergence of this disease.

scholarly journals High Proportion of Indeterminate Qua.jpegERON-TB Gold In-Tube Results in an Inpatient Population Is Related to Host Factors and Preanalytical Steps

2014 ◽  
Vol 1 (2) ◽  
Author(s):  
Valeria Fabre ◽  
Shmuel Shoham ◽  
Kathleen R. Page ◽  
Maunank Shah
Keyword(s):  
Skin Testing ◽  
Tertiary Care ◽  
Latent Tuberculosis ◽  
Host Factors ◽  
Inpatient Setting ◽  
Tuberculin Skin Testing ◽  
Sample Collection ◽  
Academic Center ◽  
Targeted Testing ◽  
Mitogen Response

Background.  Qua.jpegERON-TB Gold In-Tube test (QFT-GIT) can be used as an alternative to tuberculin skin testing (TST) for the targeted testing of latent tuberculosis. Due to many shortcomings with TST, QFT-GIT usage is increasing. QFT-GIT implementation in the inpatient setting remains unclear. Methods.  We retrospectively ide.jpegied patients admitted to a tertiary care academic center who received either a TST or a QFT-GIT in the 18 months prior to and after QFT-GIT implementation in March 2012. Risk factors associated with indeterminate results were evaluated. Results.  The proportion of inpatients receiving a test for tuberculosis infection doubled following QFT-GIT implementation (1.4% vs 2.9%). After QFT-GIT became available, 75% of tested people received a QFT-GIT and 25% received a TST. We found indeterminate test results in 19.8%. Independent predictors of indeterminate results were female sex (adjusted odds ratio [AOR], 1.64), lymphopenia (AOR, 2.21), hypoalbuminemia (AOR, 6.81) and sample collection by nonphlebotomists (AOR, 3.0, vs phlebotomists). Of patients who had indeterminate results, 42% had a subsequent indeterminate result on repeat testing. All indeterminate results were due to a low mitogen response. Conclusions.  QFT-GIT testing in the inpatient setting is associated with a high proportion of indeterminate results that is associated with host factors and preanalytical errors. Careful selection of patients to be tested and training on sample processing for QFT-GIT testing should be considered to decrease indeterminate results.

scholarly journals Is tuberculin skin testing useful to diagnose latent tuberculosis in BCG-vaccinated children?

2006 ◽  
Vol 35 (6) ◽  
pp. 1447-1454 ◽  
Author(s):  
Ma. Cecilia García-Sancho F ◽  
Lourdes García-García ◽  
Ma. Eugenia Jiménez-Corona ◽  
Manuel Palacios-Martínez ◽  
Leticia D Ferreyra-Reyes ◽  
...  
Keyword(s):  
Skin Testing ◽  
Latent Tuberculosis ◽  
Tuberculin Skin Testing

scholarly journals Prevalence of latent tuberculosis among refugee children in Malaysia

2020 ◽  
Vol 6 (1) ◽  
pp. 00254-2019 ◽  
Author(s):  
Yen Jun Wong ◽  
Shaun Wen Huey Lee
Keyword(s):  
Latent Tuberculosis ◽  
Interferon Γ ◽  
Cross Sectional Study ◽  
Preventive Therapy ◽  
Skin Tests ◽  
Refugee Children ◽  
High Risk Population ◽  
Tuberculosis Screening ◽  
Cross Sectional ◽  
Increased Risk

IntroductionTuberculosis remains one of the top 10 major causes of global mortality, imposing social–economic and medical challenges in Malaysia. Refugees sheltered in Malaysia are a high-risk population but basic health checks upon their arrival, including tuberculosis screening, are not practised. This study aimed to identify the prevalence and risk factors of tuberculosis and latent tuberculosis infection (LTBI) among refugee children in Malaysia.MethodsA cross-sectional study was performed in three refugee schools in the Klang Valley, Malaysia, using tuberculin skin tests or interferon-γ release assays. Participants who tested positive were sent for further examination with chest radiography to confirm the tuberculosis diagnosis.ResultsFrom April 2018 to April 2019, we screened 430 refugee children with a median age of 13.0 years. Most of the children were born in Myanmar (n=274, 63.7%) and Pakistan (n=60, 14.0%). No children were diagnosed with active tuberculosis but 55 of the children (12.8%) were diagnosed with LTBI. Children with LTBI were generally older (OR 3.01, 95% CI 1.71–5.29; p<0.001) than those without LTBI infection. Sex, history of bacille Calmette–Guérin vaccination and country of birth were not associated with increased risk of LTBI.ConclusionThe relatively high LTBI burden among refugee children in this study poses an indication of possible LTBI risk among this population nationwide, and thus would be an important group to target for preventive therapy. This provides a unique opportunity for researchers to further examine and implement well-structured preventive strategies in combating the endemic infectious disease in Malaysia.

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