Tuberculin Skin Test Reaction and Body Mass Index in Old Age Home Residents in Hong Kong

Chan‐Yeung, Moira; Dai, David; Cheung, Amy; Chan, Felix Hon-Wai; Kam, Kai‐Man; Tam, Cheuk‐Ming; Leung, Chi‐Chiu

doi:10.1111/j.1532-5415.2007.01316.x

Cited by 21 publications

(20 citation statements)

References 17 publications

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“…In the oldest age group there was no statistically significant change in the very high prevalence of TST positivity. Recent studies corroborate these findings revealing that TB infection in older populations has been stable or increasing in developing countries around the world, [30][31][32][33][34] making TB infection one of the most prevalent infections affecting older populations. 34 There were few differences in TST and tetanus results from 2005 11 to 2012.…”

Section: Discussionsupporting

confidence: 69%

Changes in Tuberculin Skin Test Positivity Over 20 Years in Periurban Shantytowns in Lima, Peru

Martínez

Arman

Haveman

et al. 2013

The American Society of Tropical Medicine and Hygiene

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Abstract.A cross-sectional, community-based study was performed in 2012 with 428 residents of periurban shantytowns in Lima, Peru to study risk factors for and changes in latent tuberculosis infection in age-stratified groups compared with our data from the same region in 1990 (N = 219) and 2005 (N = 103). Tuberculin skin test positivity in these communities was highly prevalent at 52% overall, increased with age (P 0.01) and was similar to 2005 (53%) and 1990 (48%). From 1990 to 2012, the prevalence of tuberculin positivity decreased in 5-14 and 15-24 year old groups (to 17% and 34%, respectively, both P 0.05). However, this may be explained by cessation of Bacille Calmette-Guérin revaccination during this period, because Bacille Calmette-Guérin revaccination doubled tuberculin positivity. Over the same 22-year period, tuberculin positivity in the 25 year old group remained high (71%, P = 0.3), suggesting that prevalent latent tuberculosis infection persists in the adult population despite improving medical care and socioeconomic development in this region.

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Section: Discussionsupporting

confidence: 69%

Changes in Tuberculin Skin Test Positivity Over 20 Years in Periurban Shantytowns in Lima, Peru

Martínez

Arman

Haveman

et al. 2013

The American Society of Tropical Medicine and Hygiene

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“…In the present study, both children [456 (30%)] and malnourished individuals [743 (49%)] were included and this could be a possible explanation for the diminished TST response owing to altered cellular- immunity in these subjects [20,21]. It was also observed that patients falling within the age group of 25–34 years had higher incidence rate as compared to pediatric patients.…”

Section: Discussionmentioning

confidence: 99%

Comparison of TST and IGRA in Diagnosis of Latent Tuberculosis Infection in a High TB-Burden Setting

et al. 2017

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BackgroundThere are currently two tests for diagnosing latent tuberculosis infection (LTBI); TST and IGRA. However, it is still unclear that which one of these tests performs better in high TB-burden settings.Methods1511 household contacts of pulmonary TB patients were enrolled to compare the performance of TST and IGRA for LTBI. At baseline all participant underwent testing for IGRA [QuantiFERON-TB® Gold In-tube (QFT-GIT) assay] and TST [2 tuberculin unit (TU), purified protein derivative (PPD), RT23, Staten Serum Institute (SSI), Copenhagen, Denmark]. All the household contacts were followed-up for two years for incident TB cases.ResultsActive TB was diagnosed in 76 household contacts at an incidence rate of 2.14 per 1000 person-years. Both, TST [Hazard Ratio (HR): 1.14, 95% confidence interval (CI): 0.72–1.79, p = 0.57], as well as QFT-GIT assay (HR: 1.66, 95% CI: 0.97–2.84, p = 0.06) results at baseline were not significantly associated with subsequent development of active TB among household contacts of pulmonary TB patients.ConclusionNeither TST nor IGRA predicted subsequent development of active TB among household contacts of pulmonary TB patients during follow-up. However, keeping in view the cost, and other logistics, TST remains the most preferred method for LTBI diagnosis in resource-limited, high TB-burden settings.

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“…Attention should also be paid to the elderly institutions due to the higher LTBI/TB prevalence in elderly congregate settings, which were widely observed in low-incidence countries like United States [8, 21, 63], and in intermediate TB burden regions like Hong Kong [64–66]. With appropriate infection control measures, the risk of infection is only 0.6–1.2% with no cases of active disease, while the infection risk can reach 7.7% without measures [67].…”

Section: Discussionmentioning

confidence: 99%

The strategic framework of tuberculosis control and prevention in the elderly: a scoping review towards End TB targets

Chung

Leung

et al. 2017

Infect Dis Poverty

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With the rapid pace of population ageing, tuberculosis (TB) in the elderly increasingly becomes a public health challenge. Despite the increasing burden and high risks for TB in the elderly, targeted strategy has not been well understood and evaluated. We undertook a scoping review to identify current TB strategies, research and policy gaps in the elderly and summarized the results within a strategic framework towards End TB targets. Databases of Embase, MEDLINE, Global health and EBM reviews were searched for original studies, review articles, and policy papers published in English between January 1990 and December 2015. Articles examining TB strategy, program, guideline or intervention in the elderly from public health perspective were included.Nineteen articles met the inclusion criteria. Most of them were qualitative studies, issued in high- and middle-income countries and after 2000. To break the chain of TB transmission and reactivation in the elderly, infection control, interventions of avoiding delay in diagnosis and containment are essential for preventing transmission, especially in elderly institutions and aged immigrants; screening of latent TB infection and preventive therapy had effective impacts on reducing the risk of reactivation and should be used less reluctantly in older people; optimizing early case-finding with a high index of suspicion, systematic screening for prioritized high-risk groups, initial empirical and adequate follow-up treatment with close monitoring and evaluation, as well as enhanced programmatic management are fundamental pillars for active TB elimination. Evaluation of TB epidemiology, risk factors, impacts and cost-effectiveness of interventions, adopting accurate and rapid diagnostic tools, shorter and less toxic preventive therapy, are critical issues for developing strategy in the elderly towards End TB targets.TB control strategies in the elderly were comprehensively mapped in a causal link pathway. The framework and principals identified in this study will help to evaluate and improve current program, develop targeted strategy, as well as raise more discussions on the research priority settings and policy transitions. Given the scarceness of policy and evaluated interventions, as well as the unawareness of shifting TB epidemiology and strategy especially in developing countries, the increasing need of a ready TB program for the elderly warrants further research.Electronic supplementary materialThe online version of this article (doi:10.1186/s40249-017-0284-4) contains supplementary material, which is available to authorized users.

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Tuberculin Skin Test Reaction and Body Mass Index in Old Age Home Residents in Hong Kong

Abstract: In the elderly population, interpretation of TST should take into consideration the BMI of the individual. A positive TST according to one-step but not two-step testing was useful in predicting the development of active TB on follow-up.

Cited by 21 publications

References 17 publications

Changes in Tuberculin Skin Test Positivity Over 20 Years in Periurban Shantytowns in Lima, Peru

Changes in Tuberculin Skin Test Positivity Over 20 Years in Periurban Shantytowns in Lima, Peru

Comparison of TST and IGRA in Diagnosis of Latent Tuberculosis Infection in a High TB-Burden Setting

The strategic framework of tuberculosis control and prevention in the elderly: a scoping review towards End TB targets

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