Validity of a self-reported history of a positive tuberculin skin test

Kunins, Hillary V.; Howard, Andrea A.; Klein, Robert S.; Arnsten, Julia H.; Litwin, Alain H.; Schoenbaum, Ellie E.; Gourevitch, Marc N.

doi:10.1111/j.1525-1497.2004.30424.x

Cited by 6 publications

(3 citation statements)

References 23 publications

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“…Compliance for a return read can be markedly improved with monetary incentives,[21, 25, 123] whereas education/counseling are generally ineffective. [21, 25] Studies examining the validity of self-reported TST history and self-assessment of TST induration[124] have yielded mixed results[28, 125]. In Rotterdam, Netherlands, establishment of a mobile unit providing chest radiographs for drug users and homeless persons contributed to a 50% decline of TB incidence in this group[126].…”

Section: Targeted Testing For Ltbimentioning

confidence: 99%

Tuberculosis and Illicit Drug Use: Review and Update

2009

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Illicit drug users continue to be a group at high risk for tuberculosis (TB) infection and disease. In this article, we present an updated review on the relationship between TB and drug use, summarizing more than a decade of new research. Drug users, and injection drug users in particular, have driven TB epidemics in a number of countries. The successful identification and treatment of TB among drug users remains an important component of a comprehensive TB strategy, but drug users present a unique set of challenges for TB diagnosis and control. New diagnostic modalities, including interferon-γ release assays (IGRAs), offer potential for improved diagnosis and surveillance among this group, alongside proven treatment strategies which incorporate the use of directly-observed therapy (DOT) with treatment for drug abuse. Special considerations, including co-infection with viral hepatitis and the Rifampin/methadone drug interaction, warrant clinical attention and are also updated here.

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Section: Targeted Testing For Ltbimentioning

confidence: 99%

Tuberculosis and Illicit Drug Use: Review and Update

2009

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“…In particular, methadone maintenance treatment programs (MMT) have successfully incorporated tuberculosis screening, including further linkage to directly observed preventive therapy for those requiring treatment (5,(18)(19)(20). MMT guidelines in the United States, as well as recommendations from the World Health Organization and Center for Disease Control and Prevention, support the continued usage of such programs as evidencebased and cost-effective (18) means of detecting and treating TB among opioid-dependent patients (21,22).…”

Section: Introductionmentioning

confidence: 98%

Comparison of Tuberculin Skin Testing Reactivity in Opioid-Dependent Patients Seeking Treatment with Methadone versus Buprenorphine: Policy Implications for Tuberculosis Screening

Schwarz¹,

Bruce²,

Ball³

et al. 2009

The American Journal of Drug and Alcohol Abuse

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“…Group A was also subdivided according to the pathologies, and subgroup A1 behaved differently from subgroups A2 and A3, both with positivity similar to that of group B. Subgroup A1, comprised by RA patients, showed a 4% prevalence of PPD reaction, much lower than that of any subgroup of chronic patients, including that of HIV positive patients and hemodialysis patients, whose response to late hypersensitivity tests, as already recognized in several studies, is jeopardized. 24,25,26,27,28,29 Two recent Brazilian studies about response to PPD in rheumatologic patients candidate to immunobiologic therapy have revealed an attenuated response to PPD in RA patients, 16,30 similar to the international findings 31,32 that attribute that abnormality to deficiencies in cell immunity of rheumatologic patients. In the study developed in Recife in 2007, the prevalence of PPD reaction in the comparison group (33.3%) was greater than that in the RA group (14.6%), with a statistically significant difference (P = 0.034).…”

Section: Discussionmentioning

confidence: 69%

Baixa prevalência de PPD reativo prévia ao uso de infliximabe: estudo comparativo em população amostral do Hospital Geral de Fortaleza

Callado¹,

Lima²,

Nobre³

et al. 2011

Rev. Bras. Reumatol.

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Objective: To identify tuberculosis infection in rheumatic patients on infliximab by use of PPD testing prior to immunobiologic therapy. Methods: This study comprised 157 patients undergoing infliximab treatment and 734 other patients undergoing laboratory screening for tuberculosis infection originating from several services. The Mantoux technique was used for PPD testing, and an induration of at least 5 mm was considered reactive status. Results: In the infliximab group, 13% of the patients reacted to PPD, while, in the other group, 27% of the patients reacted to PPD (χ 2 = 13; P = 0.0003). These patients were divided into categories: adults with chronic diseases, PPD reactivity of 22%; and other controls, PPD reactivity of 31%. This shows the heterogeneous response of that population (χ 2 = 7; P < 0.009). In the infliximab group, subdivided according to pathologies [rheumatoid arthritis (RA), ankylosing spondylitis (AS), and psoriatic arthritis (PA)], different reactivity rates were observed, the lowest value occurring among RA patients: (RA x AS: OR = 0.13; CI: 0.03-0.47; χ 2 = 12; P = 0.0004) and (RA x PA: OR = 0.16; CI: 0.02-1.04; χ 2 Yates corrected = 3.6; P = 0.05). The PPD reactivity in the RA subgroup (4%) was also lower as compared with that of the chronic patients group (22%) (OR = 0.16; CI: 0.05-0.49; χ 2 = 14; P = 0.0002), even when reclassified into four subgroups: rheumatology (OR = 0.19; CI: 0.04-0.72), kidney transplantation (OR = 0.16; CI: 0.05-0.51), infectology (OR = 0.21; CI: 0.05-0.75), and other conditions (OR = 0.13; CI: 0.04-0.44). Conclusion: The low prevalence of PPD reaction in this Brazilian population, mainly in chronic patients, with the worst performance among RA patients, shwoed that the test has limited value for diagnosis of tuberculosis infection in candidates to infliximab therapy.

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Validity of a self-reported history of a positive tuberculin skin test

Cited by 6 publications

References 23 publications

Tuberculosis and Illicit Drug Use: Review and Update

Tuberculosis and Illicit Drug Use: Review and Update

Comparison of Tuberculin Skin Testing Reactivity in Opioid-Dependent Patients Seeking Treatment with Methadone versus Buprenorphine: Policy Implications for Tuberculosis Screening

Baixa prevalência de PPD reativo prévia ao uso de infliximabe: estudo comparativo em população amostral do Hospital Geral de Fortaleza

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