scholarly journals Tuberculin Skin Testing versus Interferon-Gamma Release Assay among Users of a Public Health Unit in Northeast Portugal

2021 ◽  
pp. 1-7
Author(s):  
Andrea Luísa Fernandes Afonso ◽  
Bruno Miguel Morais Pires ◽  
Cristina Martins Teixeira ◽  
António José Nogueira
Keyword(s):  
Public Health ◽  
Risk Factors ◽  
Interferon Gamma ◽  
Healthcare Workers ◽  
Interferon Gamma Release Assay ◽  
Tuberculin Skin Testing ◽  
Health Unit ◽  
Lower Odds ◽  
Public Health Unit ◽  
The Impact

The screening of groups with a high risk for developing tuberculosis (TB) is a priority in order to control this disease. Since there is no gold standard for the diagnosis of latent TB infection (LTBI), both the tuberculin skin test (TST) and the interferon-gamma release assays (IGRA) have been used for this purpose. The aim of this study was to determine the proportion of LTBI by using the TST and the IGRA tests, and to assess the risk factors related with discordant results between tests across several risk groups advised for screening in Northeast Portugal. Data were collected from the database of patients with suspected LTBI and advised for the screening in a public health unit (January 2014 to December 2015). The proportion of LTBI was computed using both tests. Logistic regression models assessed risk factors for a positive test and for discordant results between tests. The adjusted odds ratio (OR) and respective 95% confidence interval (95% CI) were obtained. Out of 367 patients included in the analysis, 79.8% had a positive TST and 46.0% of them had a positive IGRA. In comparison with contacts of active TB cases, healthcare workers and inmates presented higher odds of TST positivity (OR 4.38, 95% CI 1.59–12.09 and OR 4.74, 95% CI 1.45–15.49, respectively), but immunocompromised people presented lower odds of TST positivity (OR 0.14; 95% CI 0.06–0.31). Instead, healthcare workers (OR 0.44, 95% CI 0.24–0.80) and immunocompromised people (OR 0.24, 95% CI 0.10–0.56) presented lower odds of a positive IGRA. There were 42.0% concordant positive results, 16.1% concordant negative results, and 41.9% discordant results, with healthcare workers presenting higher odds of discordant results (OR 3.34, 95% CI 1.84–6.05). The proportion of LTBI estimated by TST and IGRA among people advised for screening in our setting is high, highlighting the need of preventive strategies. Among healthcare workers, TST results should be read with caution as the higher proportion of discordant results with a positive TST suggests the impact of the booster reaction in this group.

scholarly journals Diagnosis and Risk Factors of Latent Tuberculosis Infection among Healthcare Workers Using Whole Blood Human Interferon-gamma Release Assay and Tuberculin Skin Testing

2020 ◽  
pp. 15-21
Author(s):  
A. N. Umo ◽  
O. J. Akinjogunla ◽  
N. O. Umoh ◽  
G. E. Uzono
Keyword(s):  
Risk Factors ◽  
Interferon Gamma ◽  
Whole Blood ◽  
Healthcare Workers ◽  
Latent Tuberculosis Infection ◽  
Latent Tuberculosis ◽  
Tuberculosis Infection ◽  
Interferon Gamma Release Assay ◽  
Tuberculin Skin Testing ◽  
Release Assay

This study established the diagnosis and risk factors of latent tuberculosis infection (LTBI) among health-care workers in an endemic population using Tuberculin skin test (TST) and Quantiferon TB-gold. A total of 609 Healthcare workers from tuberculosis treatment facilities in Akwa Ibom State, Nigeria were studied. The Interferon-gamma release assay was performed using 3ml of whole blood by ELISA according to the manufacturer’s instruction (Cellestis Ltd., Carnegie, Australia) after which 0.1 ml of 5 tuberculin units of Purified Protein Derivative (PPD) was administered intra-dermally to each subject. TST results were read after 72 hours by measuring the size of indurations in millimetres. Data were analysed using SPSS version 17 (SPSS Inc., Chicago, Illinois). At the threshold of 10 mm, the prevalence of LTBI by TST was 45.8% and 24.8% at the IGRA diagnostic value of ≥ 0.351 IU. Laboratory staff and ward orderlies as well as being in service for >10 years, were more significantly associated with LTBI. A moderate agreement of 76.7%, k = 0.51 was obtained between TST at 10 mm, and QFT. Neither previous exposure to TST nor BCG vaccination affected the prevalence of LTBI in the study population. The difference of 54% prevalence of LTBI between TST and QFT may be due to non-tuberculous mycobacterium (NTM) since TST is non-specific. This may have grave implications of drug toxicity and development of resistance to anti-TB drug among individuals harbouring NTM, but receiving anti-TB medication. The 76.7% agreement between the two tests is an indication that the 10 mm cut-off induration for TST is still relevant in the diagnosis of LTBI.

scholarly journals Interferon Gamma Release Assay versus Tuberculin Skin Testing among Healthcare Workers of Highly Diverse Origin in a Moderate Tuberculosis Burden Country

PLoS ONE ◽  
2016 ◽  
Vol 11 (5) ◽  
pp. e0154803 ◽  
Author(s):  
Sahal Al Hajoj ◽  
Bright Varghese ◽  
Alria Datijan ◽  
Mohammed Shoukri ◽  
Ali Alzahrani ◽  
...  
Keyword(s):  
Interferon Gamma ◽  
Healthcare Workers ◽  
Skin Testing ◽  
Interferon Gamma Release Assay ◽  
Tuberculin Skin Testing ◽  
Release Assay ◽  
Diverse Origin

scholarly journals The impact of COVID-19 on the care of people living with noncommunicable diseases in low- and middle-income countries: an online survey of physicians and pharmacists in nine countries

2021 ◽  
Vol 22 ◽  
Author(s):  
Chris Bullen ◽  
Jessica McCormack ◽  
Amanda Calder ◽  
Varsha Parag ◽  
Kannan Subramaniam ◽  
...  
Keyword(s):  
Public Health ◽  
Healthcare Workers ◽  
Online Survey ◽  
World Health ◽  
Noncommunicable Diseases ◽  
Middle Income ◽  
Middle Income Countries ◽  
Health Measures ◽  
The Impact ◽  
Low And Middle Income

Abstract Background: The global COVID-19 pandemic has disrupted healthcare worldwide. In low- and middle-income countries (LMICs), where people may have limited access to affordable quality care, the COVID-19 pandemic has the potential to have a particularly adverse impact on the health and healthcare of individuals with noncommunicable diseases (NCDs). A World Health Organization survey found that disruption of delivery of healthcare for NCDs was more significant in LMICs than in high-income countries. However, the study did not elicit insights into the day-to-day impacts of COVID-19 on healthcare by front-line healthcare workers (FLHCWs). Aim: To gain insights directly from FLHCWs working in countries with a high NCD burden, and thereby identify opportunities to improve the provision of healthcare during the current pandemic and in future healthcare emergencies. Methods: We recruited selected frontline healthcare workers (general practitioners, pharmacists, and other medical specialists) from nine countries to complete an online survey (n = 1347). Survey questions focused on the impact of COVID-19 pandemic on clinical practice and NCDs; barriers to clinical care during the pandemic; and innovative responses to the many challenges presented by the pandemic. Findings: The majority of FLHCWs responding to our survey reported that their care of patients had been impacted both adversely and positively by the public health measures imposed. Most FLHCs (95%) reported a deterioration in the mental health of their patients. Conclusions: Continuity of care for NCDs as part of pandemic preparedness is needed so that chronic conditions are not exacerbated by public health measures and the direct impacts of the pandemic.

scholarly journals Study of digoxin use in a public health unit

2015 ◽  
Vol 87 (2) ◽  
pp. 1033-1040 ◽  
Author(s):  
Felipe C. Souza ◽  
Emiliana B. Marques ◽  
Rogério B.M. Scaramello ◽  
B.V. Christianne
Keyword(s):  
Public Health ◽  
Heart Failure ◽  
Therapeutic Range ◽  
Systolic Dysfunction ◽  
Functional Class ◽  
Ventricular Rate ◽  
Health Unit ◽  
Class Iii ◽  
Plasma Digoxin ◽  
Public Health Unit

Digoxin is used for heart failure associated to systolic dysfunction and high ventricular rate. It has a narrow therapeutic range and intoxication may occur due to drug interactions or comorbidities. The aim of this work was to study digoxin use in a public health unit delineating the profile of patients susceptible to digitalis intoxication. Medical records belonging to patients admitted to the cardiomyopathy ward of the health unit (2009-2010) and in use of digoxin were analyzed. Among 647 patients admitted, 185 individuals using digoxin and possessed records available. The registration of plasma digoxin concentration was found in 80 records and it was out of the therapeutic range in 42 patients (52.5%). This group of individuals was constituted mainly by males patients (79%), functional class III of heart failure (65%), exhibiting renal failure (33%). The evaluated sample reflects the epidemiology of heart failure in Brazil and, although pharmacotherapy had been according to Brazilian Guidelines, apparently the monitoring was not performed as recommended. This work highlighs the necessity of plasma digoxin constant monitoring during pharmacotherapy and the development of protocols that enable a safer use, especially in male patients, functional class III and with renal dysfunction.

scholarly journals Assessing Community Empowerment for an Innovative Epidemiologic Approach

Healthcare ◽  
2020 ◽  
Vol 8 (2) ◽  
pp. 173 ◽  
Author(s):  
Pedro Melo ◽  
João Neves-Amado ◽  
Alexandra Pereira ◽  
Cândida Maciel ◽  
Tiago Vieira Pinto ◽  
...  
Keyword(s):  
Public Health ◽  
Rating Scale ◽  
Community Empowerment ◽  
Epidemiological Surveillance ◽  
Health State ◽  
Health Unit ◽  
Public Health Unit ◽  
Nursing Leaders ◽  
Nursing Diagnosis ◽  
Nursing Diagnoses

Community empowerment can be a process, but also the result of nursing care. To analyze it as a result there is an instrument that allows to quantify its level in nine domains. According to Melo (2020), health centers can be considered communities, becoming the potential target of community and public health nurses care, especially in the public health unit. One of the main functions of a public health unit is the epidemiological surveillance of the population’s health state. However, traditional epidemiological surveillance is focused on diseases and Melo (2020) proposes a new approach for epidemiology focused on people in what concerns nursing diagnosis. The aim of this research is to identify the level of empowerment of four Portuguese primary healthcare structures, named as ACeS, so as to improve the epidemiological surveillance of nursing diagnoses. As methodology, we developed four focus group with all nursing leaders from all primary care units of the four ACeS, using the Portuguese version of the empowerment assessment rating scale. The results present the level of community empowerment of each ACeS according to the nine domains of the scale. The needs of intervention to improve the ACeS empowerment were also identified in order to develop the epidemiological surveillance of nursing diagnoses.

scholarly journals Long-term efficacy of BCG vaccination in goat herds with a high prevalence of tuberculosis

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Claudia Arrieta-Villegas ◽  
Alberto Allepuz ◽  
Miriam Grasa ◽  
Maite Martín ◽  
Zoraida Cervera ◽  
...  
Keyword(s):  
Risk Factors ◽  
Interferon Gamma ◽  
Diagnostic Tests ◽  
Bcg Vaccine ◽  
Interferon Gamma Release Assay ◽  
Risk Of Infection ◽  
Bcg Vaccination ◽  
High Prevalence ◽  
Release Assay

AbstractVaccination of goats against tuberculosis (TB) has been promoted as an ancillary tool for controlling the disease in infected livestock herds. A three-year trial to assess the efficacy of BCG vaccine was carried out in five goat herds. At the beginning of the trial (month 0), all animals were tested for TB using thee different diagnostic tests. Animals negative to all tests were vaccinated with BCG and all replacement goat kids were also systematically vaccinated throughout the trial. All animals were tested by Interferon-gamma release assay (IGRA) using vaccine compatible reagents at months 6, 12, 24, and 36. The risk factors for TB infection were also evaluated. At the end of the study, four out of five farms showed variable reductions of the initial prevalence (93.5%, 28.5%, 23.2%, and 14.3% respectively), and an overall incidence reduction of 50% was observed in BCG vaccinated goats, although adult vaccinated goats showed higher incidences than vaccinated goat kids. The unvaccinated positive animals remaining in herds and adult BCG vaccinated goats significantly enhanced the risk of infection in vaccinated animals. A systematic vaccination of goats with BCG, together with the removal of positive unvaccinated animals, may contribute to reducing the TB prevalence in goat herds.

Negative Tuberculin Skin Test and Prediction of Reversion of QuantiFERON Interferon Gamma Release Assay in US Healthcare Workers

2016 ◽  
Vol 37 (4) ◽  
pp. 478-482 ◽  
Author(s):  
Wendy Thanassi ◽  
Art Noda ◽  
Beatriz Hernandez ◽  
Leah Friedman ◽  
Susan Dorman ◽  
...  
Keyword(s):  
Tuberculin Skin Test ◽  
Skin Test ◽  
Interferon Gamma ◽  
Healthcare Workers ◽  
Low Risk ◽  
Infect Control Hosp ◽  
Skin Tests ◽  
Interferon Gamma Release Assay ◽  
Negative Tuberculin Skin Test ◽  
Release Assay

QuantiFERON tuberculosis tests (QFT) reverted in (612) 77% of 1,094 low-risk healthcare workers (HCW) testing less than 1.16 IU/mL. Of HCW testing greater than 1.1 IU/mL, 33 (59%) of 56 with negative tuberculin skin tests (TST) reverted vs 8 (6%) of 125 with positive TSTs. Retesting low-risk QFT-positive and TST-negative HCW is prudent.Infect. Control Hosp. Epidemiol. 2016;37(4):478–482

Sign in / Sign up

Export Citation Format

Share Document