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Predictive Value of the Tuberculin Skin Test among Newly Arriving Immigrants

RATIONALE: Screening and treating newly arriving immigrants for latent tuberculosis infection (LTBI) in low-incidence countries could be promising to reduce the tuberculosis incidence among this population. The effectiveness of screening with the tuberculin skin test (TST) is unknown. OBJECTIVES: To...

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Autores principales: Mulder, Christiaan, Mulleners, Brigit, Borgdorff, Martien W., van Leth, Frank
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3609741/
https://www.ncbi.nlm.nih.gov/pubmed/23544128
http://dx.doi.org/10.1371/journal.pone.0060130
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author Mulder, Christiaan
Mulleners, Brigit
Borgdorff, Martien W.
van Leth, Frank
author_facet Mulder, Christiaan
Mulleners, Brigit
Borgdorff, Martien W.
van Leth, Frank
author_sort Mulder, Christiaan
collection PubMed
description RATIONALE: Screening and treating newly arriving immigrants for latent tuberculosis infection (LTBI) in low-incidence countries could be promising to reduce the tuberculosis incidence among this population. The effectiveness of screening with the tuberculin skin test (TST) is unknown. OBJECTIVES: To estimate the risk of progression to tuberculosis within two years after entry, stratified by TST result at entry. METHODS: In a case-base design, we determined the prevalence of TST positives (10 mm and 15 mm) among a representative cohort of immunocompetent immigrants (n = 643) aged ≥18 years who arrived between April 2009 and March 2011 in the Netherlands (base cohort). Immigrants who progressed to tuberculosis within two years after arrival in 2005, 2006 or 2007 were extracted from the Netherlands Tuberculosis Register (case source cohort). The prevalence of TST positives from the base cohort was projected on the case source cohort to estimate the risk of progression to active tuberculosis by using Bayesian analyses to adjust for the sensitivity of the TST and Poisson regression analyses to take into account the random error of the number of extracted cases. RESULTS: The prevalence of TST positives was 42% and 23% for a cut-off value of 10 mm and 15 mm, respectively. The overall risk of progression to tuberculosis if TST positive was 238 per 100,000 population (95% CI 151–343) and 295 per 100,000 population (95% CI 161–473) for a cut-off value of ≥10 mm and ≥15 mm, respectively. The corresponding risk for TST negatives was 19 (95% CI 0–59) and 58 (95% CI 25–103). CONCLUSION: The TST has the discriminatory ability to differentiate between individuals at low and high risk of disease.
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spelling pubmed-36097412013-03-29 Predictive Value of the Tuberculin Skin Test among Newly Arriving Immigrants Mulder, Christiaan Mulleners, Brigit Borgdorff, Martien W. van Leth, Frank PLoS One Research Article RATIONALE: Screening and treating newly arriving immigrants for latent tuberculosis infection (LTBI) in low-incidence countries could be promising to reduce the tuberculosis incidence among this population. The effectiveness of screening with the tuberculin skin test (TST) is unknown. OBJECTIVES: To estimate the risk of progression to tuberculosis within two years after entry, stratified by TST result at entry. METHODS: In a case-base design, we determined the prevalence of TST positives (10 mm and 15 mm) among a representative cohort of immunocompetent immigrants (n = 643) aged ≥18 years who arrived between April 2009 and March 2011 in the Netherlands (base cohort). Immigrants who progressed to tuberculosis within two years after arrival in 2005, 2006 or 2007 were extracted from the Netherlands Tuberculosis Register (case source cohort). The prevalence of TST positives from the base cohort was projected on the case source cohort to estimate the risk of progression to active tuberculosis by using Bayesian analyses to adjust for the sensitivity of the TST and Poisson regression analyses to take into account the random error of the number of extracted cases. RESULTS: The prevalence of TST positives was 42% and 23% for a cut-off value of 10 mm and 15 mm, respectively. The overall risk of progression to tuberculosis if TST positive was 238 per 100,000 population (95% CI 151–343) and 295 per 100,000 population (95% CI 161–473) for a cut-off value of ≥10 mm and ≥15 mm, respectively. The corresponding risk for TST negatives was 19 (95% CI 0–59) and 58 (95% CI 25–103). CONCLUSION: The TST has the discriminatory ability to differentiate between individuals at low and high risk of disease. Public Library of Science 2013-03-27 /pmc/articles/PMC3609741/ /pubmed/23544128 http://dx.doi.org/10.1371/journal.pone.0060130 Text en © 2013 Mulder et al http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited.
spellingShingle Research Article
Mulder, Christiaan
Mulleners, Brigit
Borgdorff, Martien W.
van Leth, Frank
Predictive Value of the Tuberculin Skin Test among Newly Arriving Immigrants
title Predictive Value of the Tuberculin Skin Test among Newly Arriving Immigrants
title_full Predictive Value of the Tuberculin Skin Test among Newly Arriving Immigrants
title_fullStr Predictive Value of the Tuberculin Skin Test among Newly Arriving Immigrants
title_full_unstemmed Predictive Value of the Tuberculin Skin Test among Newly Arriving Immigrants
title_short Predictive Value of the Tuberculin Skin Test among Newly Arriving Immigrants
title_sort predictive value of the tuberculin skin test among newly arriving immigrants
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3609741/
https://www.ncbi.nlm.nih.gov/pubmed/23544128
http://dx.doi.org/10.1371/journal.pone.0060130
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