Tuberculosis Returns

PEDIATRICS ◽  
1982 ◽  
Vol 70 (3) ◽  
pp. 502-502
Author(s):  
Robert J. Leggiadro ◽  
Farah Olga Laaly
Keyword(s):  
Optimal Control ◽  
High Risk ◽  
Skin Testing ◽  
Urban Children ◽  
Active Tuberculosis ◽  
Recent Experience ◽  
Tuberculin Skin Testing ◽  
Tuberculosis Control ◽  
Risk Areas ◽  
Close Contacts

We read with interest "Apparent Resurgence of Tuberculosis in Urban Children" by Inselman et al.1 The authors emphasized the continued need for routine tuberculin skin testing in children, especially those in high-risk areas. We agree and wish to underscore further aspects of tuberculosis control. Our recent experience at a suburban county hospital serves to remind the clinician that aggressive identification and appropriate management of close contacts of patients with active tuberculosis remain critically important in terms of individual morbidity and mortality and optimal control of the disease.2

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 QuantiFERON-TB Gold In-Tube in Saudi Arabia benchmarked with other sites of the Middle East: A meta-analysis review

2018 ◽  
Vol 12 (09) ◽  
pp. 687-699
Author(s):  
Hawra Al-Ghafli ◽  
Sahal Al-Hajoj
Keyword(s):  
Saudi Arabia ◽  
High Risk ◽  
Middle East ◽  
Publication Bias ◽  
Meta Analysis ◽  
Skin Testing ◽  
Random Effect ◽  
Random Effect Model ◽  
Risk Groups ◽  
Tuberculin Skin Testing

Introduction: Screening for Latent Tuberculosis Infections (LTBI) constitutes a key step in health surveillance programs especially among adults of high-risk groups. To our knowledge, this is the first systematic and meta-analysis review that aims to critically assess and compare the agreement of QuantiFERON-TB Gold In-Tube (QFT-GIT) and Tuberculin Skin Testing (TST) among adults of high-risk groups in Saudi Arabia and compare results with other sites of the Middle East. Methodology: Kappa estimates were meta-analyzed using random effect model and several subgroup analyzes were performed to explain overall heterogeneity. Funnel plot, Begg’s and Egger’s tests were employed to assess overall publication bias. Results: 18 studies were meta-analyzed, comprising 5070 adults of high-risk groups. Pooled kappa estimates from Saudi Arabia (κ = 0.29, 95% CI: 0.16, 0.41) showed lower rate of agreement compared to other sites of the Middle East (κ = 0.33, 95% CI: 0.25, 0.41). However, a significant level of heterogeneity (I2 = 96.7%, p > 0.001) were identified across collected evidence. Begg’s and Egger’s tests confirmed absence of significant publication bias in this review (p = 0.49 and p = 0.16, respectively). Conclusion: This work revealed fair to poor agreement between TST and QFT-GIT, indicating that these two tests are not interchangeable in such settings. Substantial evidence is still needed before considering the sole use of QFT-GIT as an alternative to TST in these populations. Moreover, there is an urgent need for longitudinal studies in Saudi Arabia and the Middle East to accurately assess precision of LTBI diagnosis.

A Question on Tuberculin Testing

PEDIATRICS ◽  
1975 ◽  
Vol 56 (4) ◽  
pp. 619-619
Author(s):  
Martin I. Lorin
Keyword(s):  
Health Care ◽  
High Risk ◽  
Health Care Delivery ◽  
Care Delivery ◽  
Skin Testing ◽  
Tuberculin Skin Testing ◽  
Seeking Help ◽  
Tuberculin Testing ◽  
Risk Communities

The practitioner seeking help and guidance in the use of tuberculin screening as a part of health care delivery will find little comfort in the pronouncements of the various pediatric pundits in the November issue of Pediatrics. Dr. Edwards and Dr. North both state in the section Pediatrics for the Clinician that the routine use of tuberculin skin testing can no longer be recommended and that it should be restricted to specific high-risk communities. Dr. Edwards1 provides some of the data and figures upon which this recommendation is based.

Prevention and Control of Tuberculosis

1985 ◽  
Vol 6 (4) ◽  
pp. 169-171 ◽  
Author(s):  
William M. Valenti
Keyword(s):  
Skin Testing ◽  
Care Facility ◽  
Health Care Facility ◽  
Control Program ◽  
Health Programs ◽  
Tuberculin Skin Testing ◽  
Tuberculosis Control ◽  
Individual Health ◽  
The Individual ◽  
And Control

One activity of most employee health programs is a tuberculosis control program. No two programs will be exactly the same since many of the components of this program are controversial. Each should be tailored to the needs of the individual health care facility. In general, there are two components of a program for tuberculin skin testing of employees:1. Skin testing prior to exposure.2. Skin testing after exposure.

Interferon-γ Release Assay vs. Tuberculin Skin Test for Tuberculosis Screening in Exposed Healthcare Workers: A Longitudinal Multicenter Comparative Study

2015 ◽  
Vol 36 (5) ◽  
pp. 569-574 ◽  
Author(s):  
Jean-Christophe Lucet ◽  
Dominique Abiteboul ◽  
Candice Estellat ◽  
Carine Roy ◽  
Sylvie Chollet-Martin ◽  
...  
Keyword(s):  
High Risk ◽  
Healthcare Workers ◽  
Skin Testing ◽  
Interferon Γ ◽  
Tuberculin Skin Testing ◽  
Tuberculosis Screening ◽  
Clinical Trial Registration ◽  
Current Function ◽  
History Of ◽  
Release Assay

OBJECTIVEHealthcare workers (HCWs), especially those caring for patients with tuberculosis (TB), are at high risk of acquiring that disease. The poor specificity of tuberculin skin testing (TST) prompted us to evaluate the effectiveness of the interferon-γ release assay (IGRA) in comparison with TST in a large prospective, multicenter, 1-year study of HCWs with occupational exposure to TB.METHODSHCWs from high-risk units at 14 university hospitals were invited to participate and underwent both TST and IGRA (first Quantiferon TB Gold-IT®, QFT-G, then T-SPOT.TB® if QFT-G was indeterminate) at baseline and after 1 year. We collected demographic characteristics, country of birth, history of TB, immunosuppression, past exposure to TB, history of BCG vaccination, results of most recent TST, job category, and duration of current function.RESULTSAmong 807 HCWs enrolled, current or past TST at baseline was positive (≥15 mm) in 282 (34.9%); the IGRA was positive in 113 (14.0%) and indeterminate in 3 (0.4%). After 1 year, 594 HCWs had both an IGRA and TST (or prior TST≥15 mm) at baseline and an IGRA and TST (if indicated). The conversion rate was 2.5% (9 of 367) with TST and 7.6% (45 of 594) with IGRA, with poor agreement between the 2 tests. Using only QFT-G, conversion (9.9%) and reversion (17.8%) rates were higher for baseline QFT-G positive quantitative values <1 IU/mL.CONCLUSIONTST and the IGRA yielded discordant results. The value of IGRA in addition to TST remains undetermined; the two should be jointly interpreted in decision-making (clinical trial registration NCT00797836).Infect Control Hosp Epidemiol 2015;00(0): 1–6

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