The Prevalence Rate of Tuberculin Skin Test Positive by Contacts Group to Predict the Development of Active Tuberculosis After School Outbreaks.
10.4046/trd.2015.78.4.349
- Author:
Hee Jin KIM
1
;
Byung Chul CHUN
;
AmyM KWON
;
Gyeong Ho LEE
;
Sungweon RYU
;
Soo Yeon OH
;
Jin Beom LEE
;
Se Hwa YOO
;
Eui Sook KIM
;
Je Hyeong KIM
;
Chol SHIN
;
Seung Heon LEE
Author Information
1. Korean Institute of Tuberculosis, Cheongwon, Korea.
- Publication Type:Original Article
- Keywords:
Adolescent;
Disease Outbreaks;
Tuberculin Test;
Latent Tuberculosis;
Tuberculosis
- MeSH:
Adolescent;
Area Under Curve;
Disease Outbreaks*;
Follow-Up Studies;
Humans;
Latent Tuberculosis;
Mass Screening;
National Health Programs;
Prevalence*;
Skin Tests*;
Skin*;
Tuberculin Test;
Tuberculin*;
Tuberculosis*
- From:Tuberculosis and Respiratory Diseases
2015;78(4):349-355
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: The tuberculin skin test (TST) is the standard tool to diagnose latent tuberculosis infection (LTBI) in mass screening. The aim of this study is to find an optimal cut-off point of the TST+ rate within tuberculosis (TB) contacts to predict the active TB development among adolescents in school TB outbreaks. METHODS: The Korean National Health Insurance Review and Assessment database was used to identify active TB development in relation to the initial TST (cut-off, 10 mm). The 7,475 contacts in 89 schools were divided into two groups: Incident TB group (43 schools) and no incident TB group (46 schools). LTBI treatment was initiated in 607 of the 1,761 TST+ contacts. The association with active TB progression was examined at different cut-off points of the TST+ rate. RESULTS: The mean duration of follow-up was 3.9+/-0.9 years. Thirty-three contacts developed active TB during the 4,504 person-years among the TST+ contacts without LTBI treatment (n=1,154). The average TST+ rate for the incident TB group (n=43) and no incident TB group (n=46) were 31.0% and 15.5%, respectively. The TST+ rate per group was related with TB progression (odds ratio [OR], 1.025; 95% confidence interval [CI], 1.001-1.050; p=0.037). Based on the TST+ rate per group, active TB was best predicted at TST+ > or = 16% (OR, 3.11; 95% CI, 1.29-7.51; area under curve, 0.64). CONCLUSION: Sixteen percent of the TST+ rate per group within the same grade students can be suggested as an optimal cut-off to predict active TB development in middle and high schools TB outbreaks.
