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Clinical and epidemiological characteristics of individuals resistant to M. tuberculosis infection in a longitudinal TB household contact study in Kampala, Uganda

BACKGROUND: Despite sustained exposure to a person with pulmonary tuberculosis (TB), some M. tuberculosis (Mtb) exposed individuals maintain a negative tuberculin skin test (TST). Our objective was to characterize these persistently negative TST (PTST-) individuals and compare them to TST converters...

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Autores principales: Ma, Ningning, Zalwango, Sarah, Malone, LaShaunda L, Nsereko, Mary, Wampande, Eddie M, Thiel, Bonnie A, Okware, Brenda, Igo, Robert P, Joloba, Moses L, Mupere, Ezekiel, Mayanja-Kizza, Harriet, Boom, W Henry, Stein, Catherine M
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4091673/
https://www.ncbi.nlm.nih.gov/pubmed/24970328
http://dx.doi.org/10.1186/1471-2334-14-352
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author Ma, Ningning
Zalwango, Sarah
Malone, LaShaunda L
Nsereko, Mary
Wampande, Eddie M
Thiel, Bonnie A
Okware, Brenda
Igo, Robert P
Joloba, Moses L
Mupere, Ezekiel
Mayanja-Kizza, Harriet
Boom, W Henry
Stein, Catherine M
author_facet Ma, Ningning
Zalwango, Sarah
Malone, LaShaunda L
Nsereko, Mary
Wampande, Eddie M
Thiel, Bonnie A
Okware, Brenda
Igo, Robert P
Joloba, Moses L
Mupere, Ezekiel
Mayanja-Kizza, Harriet
Boom, W Henry
Stein, Catherine M
author_sort Ma, Ningning
collection PubMed
description BACKGROUND: Despite sustained exposure to a person with pulmonary tuberculosis (TB), some M. tuberculosis (Mtb) exposed individuals maintain a negative tuberculin skin test (TST). Our objective was to characterize these persistently negative TST (PTST-) individuals and compare them to TST converters (TSTC) and individuals who are TST positive at study enrollment. METHODS: During a TB household contact study in Kampala, Uganda, PTST-, TSTC, and TST + individuals were identified. PTST- individuals maintained a negative TST over a 2 year observation period despite prolonged exposure to an infectious tuberculosis (TB) case. Epidemiological and clinical characteristics were compared, a risk score developed by another group to capture risk for Mtb infection was computed, and an ordinal regression was performed. RESULTS: When analyzed independently, epidemiological risk factors increased in prevalence from PTST- to TSTC to TST+. An ordinal regression model suggested age (p < 0.01), number of windows (p < 0.01) and people (p = 0.07) in the home, and sleeping in the same room (p < 0.01) were associated with PTST- and TSTC. As these factors do not exist in isolation, we examined a risk score, which reflects an accumulation of risk factors. This compound exposure score did not differ significantly between PTST-, TSTC, and TST+, except for the 5–15 age group (p = 0.009). CONCLUSIONS: Though many individual factors differed across all three groups, an exposure risk score reflecting a collection of risk factors did not differ for PTST-, TSTC and TST + young children and adults. This is the first study to rigorously characterize the epidemiologic risk profile of individuals with persistently negative TSTs despite close exposure to a person with TB. Additional studies are needed to characterize possible epidemiologic and host factors associated with this phenotype.
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spelling pubmed-40916732014-07-11 Clinical and epidemiological characteristics of individuals resistant to M. tuberculosis infection in a longitudinal TB household contact study in Kampala, Uganda Ma, Ningning Zalwango, Sarah Malone, LaShaunda L Nsereko, Mary Wampande, Eddie M Thiel, Bonnie A Okware, Brenda Igo, Robert P Joloba, Moses L Mupere, Ezekiel Mayanja-Kizza, Harriet Boom, W Henry Stein, Catherine M BMC Infect Dis Research Article BACKGROUND: Despite sustained exposure to a person with pulmonary tuberculosis (TB), some M. tuberculosis (Mtb) exposed individuals maintain a negative tuberculin skin test (TST). Our objective was to characterize these persistently negative TST (PTST-) individuals and compare them to TST converters (TSTC) and individuals who are TST positive at study enrollment. METHODS: During a TB household contact study in Kampala, Uganda, PTST-, TSTC, and TST + individuals were identified. PTST- individuals maintained a negative TST over a 2 year observation period despite prolonged exposure to an infectious tuberculosis (TB) case. Epidemiological and clinical characteristics were compared, a risk score developed by another group to capture risk for Mtb infection was computed, and an ordinal regression was performed. RESULTS: When analyzed independently, epidemiological risk factors increased in prevalence from PTST- to TSTC to TST+. An ordinal regression model suggested age (p < 0.01), number of windows (p < 0.01) and people (p = 0.07) in the home, and sleeping in the same room (p < 0.01) were associated with PTST- and TSTC. As these factors do not exist in isolation, we examined a risk score, which reflects an accumulation of risk factors. This compound exposure score did not differ significantly between PTST-, TSTC, and TST+, except for the 5–15 age group (p = 0.009). CONCLUSIONS: Though many individual factors differed across all three groups, an exposure risk score reflecting a collection of risk factors did not differ for PTST-, TSTC and TST + young children and adults. This is the first study to rigorously characterize the epidemiologic risk profile of individuals with persistently negative TSTs despite close exposure to a person with TB. Additional studies are needed to characterize possible epidemiologic and host factors associated with this phenotype. BioMed Central 2014-06-27 /pmc/articles/PMC4091673/ /pubmed/24970328 http://dx.doi.org/10.1186/1471-2334-14-352 Text en Copyright © 2014 Ma et al.; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/4.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Ma, Ningning
Zalwango, Sarah
Malone, LaShaunda L
Nsereko, Mary
Wampande, Eddie M
Thiel, Bonnie A
Okware, Brenda
Igo, Robert P
Joloba, Moses L
Mupere, Ezekiel
Mayanja-Kizza, Harriet
Boom, W Henry
Stein, Catherine M
Clinical and epidemiological characteristics of individuals resistant to M. tuberculosis infection in a longitudinal TB household contact study in Kampala, Uganda
title Clinical and epidemiological characteristics of individuals resistant to M. tuberculosis infection in a longitudinal TB household contact study in Kampala, Uganda
title_full Clinical and epidemiological characteristics of individuals resistant to M. tuberculosis infection in a longitudinal TB household contact study in Kampala, Uganda
title_fullStr Clinical and epidemiological characteristics of individuals resistant to M. tuberculosis infection in a longitudinal TB household contact study in Kampala, Uganda
title_full_unstemmed Clinical and epidemiological characteristics of individuals resistant to M. tuberculosis infection in a longitudinal TB household contact study in Kampala, Uganda
title_short Clinical and epidemiological characteristics of individuals resistant to M. tuberculosis infection in a longitudinal TB household contact study in Kampala, Uganda
title_sort clinical and epidemiological characteristics of individuals resistant to m. tuberculosis infection in a longitudinal tb household contact study in kampala, uganda
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4091673/
https://www.ncbi.nlm.nih.gov/pubmed/24970328
http://dx.doi.org/10.1186/1471-2334-14-352
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