Current tuberculin reactivity of schoolchildren in the Central African Republic

Minime-Lingoupou, Fanny; Ouambita-Mabo, Rock; Komangoya-Nzozo, Aristide-Désiré; Senekian, Dominique; Bate, Lucien; Yango, F.; Nambea, Bachir; Manirakiza, Alexandre

doi:10.1186/s12889-015-1829-8

Cited by 4 publications

(4 citation statements)

References 17 publications

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“…The majority of children (81.8%) did not have any reaction to tuberculin, despite having received BCG immunization soon after birth. Same finding was found in some studies (29,30,31,32,33 ).Poor effect of BCG vaccine on tuberculin reactivity encourages the use of TST for estimation of prevalence of TB infection. Association of BCG scar and TST was reported (21,34,35).…”

Section: Discussionsupporting

confidence: 76%

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Reactivity of tuberculin among Bacillus Calmette-Guérin vaccinated school children, Kassala State, Sudan Fatima A. Khalid1. Elderidiry MM2, MM Mukhta3

Khalid

Eldirdery

Mukhtar

2019

Preprint

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Background Tuberculin skin test (TST) is a delayed hypersensitivity reaction of latent TB infected patients and BCG vaccinated individuals. It is recommended for screening of mycobacterium infection in many countries. Kassala state in eastern Sudan is known as the highest pulmonary TB endemic region in Sudan. Little data is available on the TST reactivity among school children in Kassala. This activity aimed to measure the prevalence of TST reactivity among school children in Kassala as indictor for exposure and response to BCG vaccination. Method Five tuberculin units of PPD were injected intradermally in the left forearm of 2600 children aged 5-15 years attending governmental basic schools in Kassala. BCG scar, child health and nutrition status were assessed before the test. The reactivity of TST was read for 2568 children after 48- 72 hours, interpreted at different cut-off level based on published guidelines. Data were analyzed using SPSS (V. 20.0) Results Tuberculin reactivity was measured to 2568 out of the 2600, 32 were absent during the measurement. Most of children 2100 (81.8%) had no reaction with TST (no induration). Four hundred and sixty eight (18.2%) had induration ranged from 1mm to 28 mm with mean 3.1mm ±3.29, among them, 17 cases had induration ranged from 10- 28mm. prevalence of BCG scar was 1688 (64.9%). TST reactivity was statistically associated with geographical localities, child gender, and age (P<0.001). High percentage of TST reactivity was recorded in females (65.8%) compared to males (34.1%). Furthermore, TST reactivity was increased with the age, among the strong positive reaction, 9/17 were in age 13-15 years. Also TST reactivity was statistically correlated with nutrition and socioeconomic status ((P<0.001). TST reactivity was not affected by BCG vaccine (P>0.05). Conclusion The study provides data on BCG vaccination coverage in Kassala state, the prevalence of non reactivity of TST. No effect of BCG vaccine on reactivity of TST, hence it can be used as the diagnostic tool for detection of LTBI in children. Different confounding factors were associated with TST reactivity including child age, gender and nutrition status, health and socioeconomic status.

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Section: Discussionsupporting

confidence: 76%

“…Non reactivity of TST can be related to the strain of BCG used for vaccination and the time interval between vaccination and TST. Prevalence of positive tuberculin skin test reactions has been reported in many studies in different parts of the world (30,35).…”

Section: Discussionmentioning

confidence: 97%

Reactivity of tuberculin among Bacillus Calmette-Guérin vaccinated school children, Kassala State, Sudan Fatima A. Khalid1. Elderidiry MM2, MM Mukhta3

Khalid

Eldirdery

Mukhtar

2019

Preprint

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“…The ARTI we estimated in KZN seemed higher than the 0.7% estimated in Tanzania and the 1.1% estimated in Kenya (bimodal distributions, both surveys used the fixed mirror method) [ 47 , 48 ], the 0.8% estimated in Gambia (analysed as a bimodal distribution, ≥12mm from mixture analysis) [ 49 ], ARTI estimates from a survey in Ghana, where a variety of district level ARTI estimates were presented (bimodal distribution) [ 50 ], and much higher than the 0.1% ARTI estimate from Kassala State, Sudan (distribution not provided, ≥10mm threshold) [ 51 ]. Published estimates of the ARTI in Central African Republic do not account for striking digit preference and are likely, therefore, to overestimate the force of infection [ 52 ].…”

Section: Discussionmentioning

confidence: 99%

Tuberculin skin test surveys and the Annual Risk of Tuberculous Infection in school children in Northern KwaZulu-Natal

Yates,

Cebekhulu,

Mthethwa

et al. 2024

PLOS Glob Public Health

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Tuberculin skin test surveys in primary school children can be used to quantify Mycobacterium tuberculosis transmission at community level. KwaZulu-Natal province, South Africa, is home to 11.5 million people and suffers a burden of tuberculosis disease that is among the highest in the world. The last tuberculin survey in the province was undertaken in 1979. We performed a tuberculin skin test survey nested within a demographic and health household surveillance programme in Northern KwaZulu-Natal. We enrolled children aged between six and eight years of age attending primary schools in this community. Mixture analysis was used to determine tuberculin skin test thresholds and the Annual Risk of Tuberculous Infection derived from age at testing and infection prevalence. The Community Infection Ratio, a measure of the relative importance of within-household and community transmission, was calculated from data on tuberculin positivity disaggregated by household tuberculosis contact. Between June and December 2013, we obtained tuberculin skin test results on 1240 children. Mixture analysis proved unstable, suggesting two potential thresholds for test positivity. Using a threshold of ≥10mm or treating all non zero reactions as positive yielded estimates of the Annual Risk of Tuberculous Infection of 1.7% (1.4–2.1%) or 2.4% (2.0–3.0%). Using the same thresholds and including children reported to be receiving TB treatment as cases, resulted in estimates of 2.0% (1.6–2.5%) or 2.7% (2.2–3.3%). The Community Infection Ratio was 0.58 (0.33–1.01). The force of infection in this community is lower than that observed in Western Cape province, South Africa, but higher than that observed in community settings in most other parts of the world. Children in this community are commonly infected with Mycobacterium tuberculosis outside the home. Interventions to interrupt transmission are urgently needed.

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“…[ 27 ] A recent survey in the Central Africa region reported similar ARTIs using 10 mm (1.9%) and 15 mm (0.8%) cut-offs. [ 28 ]…”

Section: Discussionmentioning

confidence: 99%

A Tuberculin Skin Test Survey and the Annual Risk of Mycobacterium tuberculosis Infection in Gambian School Children

et al. 2015

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BackgroundA Tuberculin skin test (TST) survey was conducted to assess the prevalence of latent TB Infection (LTBI) and to estimate the annual risk of M. tuberculosis infection (ARTI) in Gambian school children. The results are expected to contribute to understanding of Tuberculosis epidemiology in The Gambia.MethodsThis was a nationwide, multi-cluster survey in children aged 6–11 years. Districts, 20 of 37, were selected by probability proportional to size and schools by simple random sampling. All TST were performed using the Mantoux method. Height and weight measurements were obtained for all participants. We calculated prevalence of LTBI using cut-off points of 10mm, the mirror and mixture modelling methods.ResultsTST readings were completed 13,386 children with median age of 9 years (interquartile range [IQR] 8–10 years). Mixture analysis yielded a cut-off point of 12 mm, and LTBI prevalence of 6.9% [95%CI 6.47–7.37] and the ARTI was 0.75% [95%CI 0.60–0.91]. LTBI was associated gender and urban residence (p <0.01). Nutritional status was not associated with non-reactive TST or sizes of TST indurations. ARTI did not differ significantly by age, gender, BCG vaccination or residence.ConclusionsThis estimates for LTBI prevalence and ARTI were low but this survey provides updated data. Malnutrition did not affect estimates of LTBI and ARTI. Given the low ARTI in this survey and the overlapping distribution of indurations with mixture modelling, further surveys may require complementary tests such as interferon gamma release assays or novel diagnostic tools.

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Current tuberculin reactivity of schoolchildren in the Central African Republic

Cited by 4 publications

References 17 publications

Reactivity of tuberculin among Bacillus Calmette-Guérin vaccinated school children, Kassala State, Sudan Fatima A. Khalid1. Elderidiry MM2, MM Mukhta3

Reactivity of tuberculin among Bacillus Calmette-Guérin vaccinated school children, Kassala State, Sudan Fatima A. Khalid1. Elderidiry MM2, MM Mukhta3

Tuberculin skin test surveys and the Annual Risk of Tuberculous Infection in school children in Northern KwaZulu-Natal

A Tuberculin Skin Test Survey and the Annual Risk of Mycobacterium tuberculosis Infection in Gambian School Children

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