Providing detailed information about latent tuberculosis and compliance with the PPD test among healthcare workers in Israel: A randomized controlled study

Taubman, Danielle S.; Titler, Nava; Edelstein, Hana; Elias, Mazen; Saliba, Walid

doi:10.1016/j.jegh.2013.06.003

Cited by 5 publications

(5 citation statements)

References 15 publications

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“…The TST is performed by injecting PPD into an individual's forearm and observing the skin induration reaction after 48 h or 72 h from the injection. Although the TST has been the standard for the identification of MTB infection for the past century, it cannot effectively distinguish between MTB infection and either nontuberculous mycobacteria (NTM) infection or Bacillus Calmette-Guérin (BCG) vaccination due to the presence of homologous antigens in PPD [11,12]. Therefore, the TST suffers from high false positive rate and low specificity [13], and these limitations have led to the development of more effective immunodiagnostic tools to identify LTBI.…”

Section: Introductionmentioning

confidence: 99%

A Comparative Study on the Mechanism of Delayed-Type Hypersensitivity Mediated by the Recombinant Mycobacterium tuberculosis Fusion Protein ESAT6-CFP10 and Purified Protein Derivative

Guo,

Du,

et al. 2023

IJMS

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While purified protein derivative (PPD) is commonly used as skin diagnostic reagent for tuberculosis (TB) infection, it cannot distinguish effectively Bacillus Calmette–Guérin (BCG) vaccination from Mycobacterium tuberculosis (MTB) complex and nontuberculous mycobacteria infection. The new skin reagent ESAT6-CFP10 (EC) has favorable sensitivity and specificity, which can overcome limitations associated with PPD. At present, EC skin test reactions are mainly characterized by erythema, while PPD mainly causes induration. We conducted a comparative study on the potential differences between EC-induced erythema and PPD-induced induration using a guinea pig model. The size of EC-dependent erythema was similar to that of PPD-induced induration, and an inflammatory response characterized by the infiltration of monocytes, macrophages and lymphocytes, as well as tissue damage, appeared at the injection site. The lymphocytes included CD4+ T and CD8+ T cells, which released IFN-γ as the main cytokine. Both EC erythema and PPD induration could lead to increased levels of acute-phase proteins, and the differential pathways were similar, thus indicating that the main induced immune pathways were similar. The above results indicated that erythema produced by EC could generate the main delayed-type hypersensitivity (DTH) response characteristic of PPD induration, thereby suggesting that erythema might also have a certain diagnostic significance and provide a possible theoretical basis for its use as a diagnostic indicator for detecting MTB infection.

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Section: Introductionmentioning

confidence: 99%

A Comparative Study on the Mechanism of Delayed-Type Hypersensitivity Mediated by the Recombinant Mycobacterium tuberculosis Fusion Protein ESAT6-CFP10 and Purified Protein Derivative

Guo,

Du,

et al. 2023

IJMS

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“…The risk of progression of LTBI, defined as the presence of mycobacterium TB bacteria without the manifestation of signs or symptoms, to TB disease is highest during the first years after infection [4] . Several studies have shown that HCWs are not compliant with screening and/or preventive measures [7,8,9] . Such data have led to a growing interest in improving the detection and proper management of TB infection among HCWs.…”

Section: Introductionmentioning

confidence: 99%

Compliance with Screening and Treatment of Latent Tuberculosis among Health Care Workers in a Lebanese Hospital

Farah

Rizk

Khazen

et al. 2021

ijirms

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Background: Health care workers (HCWs) are at increased risk of Tuberculosis infection. Various Guidelines recommend pre-placement, post-exposure, and annual screening for latent tuberculosis among HCWs. Aim: to assess the compliance of HCWs with these protocols. In addition, the study aimed to evaluate the compliance with treatment of Latent Tuberculosis and reasons of non-adherence. Methods: Study was conducted on 560 HCWs in a Lebanese hospital. A Questionnaire col-lected data on knowledge about latent tuberculosis, post-exposure screening and the reasons behind non adherence to treatment. A retrospective chart review on the same HCWs revealed data regarding TST pre-employment status, compliance to screening, seroconversion and compliance to treatment. Results: 69% of HCWs did not attend a lecture on Tuberculosis. 76% were aware of screen-ing policies. 88% performed pre-placement testing. 29% were screened post exposure. Only 4.3% had their PPD done annually. 8 HCWs seroconverted; Only 59% of positive employees initiated treatment. . Reasons included refusal or belief of no treatment benefit (55%), not being prescribed a treatment (33%), Contraindications (8%), and being afraid of side effects (4%). 15% of those who received treatment were not able to complete the full course mainly due to side effects (80%). Conclusion: We reported acceptable rates of pre-placement screening, low rates of annual screening and post exposure screening. We also reported fair rates of initiation and comple-tion of LTBI treatment. We recommend an administrative initiative to strongly implement the policies of screening for LTBI.

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“…11e13 Current diagnostic tests for tuberculosis, which are based on tuberculin, have poor specificity because BCG vaccination and exposure to nontuberculosis mycobacterium produce a similar response as infection with genuine M. tb. 14,15 The PCR assay has a sensitivity and specificity for the TB of sputum and extrapulmonary tuberculosis. 16e18 However, this technology needs expensive reagents and instruments and does not distinguish between living and dead bacteria for clinical judgment.…”

Section: Introductionmentioning

confidence: 99%

CFP10 and ESAT6 aptamers as effective Mycobacterial antigen diagnostic reagents

Tang

Zhou

et al. 2014

Journal of Infection

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Providing detailed information about latent tuberculosis and compliance with the PPD test among healthcare workers in Israel: A randomized controlled study

Cited by 5 publications

References 15 publications

A Comparative Study on the Mechanism of Delayed-Type Hypersensitivity Mediated by the Recombinant Mycobacterium tuberculosis Fusion Protein ESAT6-CFP10 and Purified Protein Derivative

A Comparative Study on the Mechanism of Delayed-Type Hypersensitivity Mediated by the Recombinant Mycobacterium tuberculosis Fusion Protein ESAT6-CFP10 and Purified Protein Derivative

Compliance with Screening and Treatment of Latent Tuberculosis among Health Care Workers in a Lebanese Hospital

CFP10 and ESAT6 aptamers as effective Mycobacterial antigen diagnostic reagents

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