BACKGROUND/AIMS: We investigated the agreement between the QuantiFERON-TB Gold (QFT-Gold) test and the tuberculin skin test (TST) in the diagnosis of latent tuberculosis infection in patients with rheumatoid arthritis (RA), compared with healthy controls, in Korea. METHODS: We recruited 64 patients with RA and 79 healthy controls at two university hospitals in South Korea. The participants underwent both the QFT-Gold test and the TST simultaneously between August 2006 and February 2009. All patients were diagnosed using the classification criteria for RA revised in 1987 by the American College of Rheumatology. Bacillus Calmette-Guerin vaccination status and current medications were evaluated, and disease activities were assessed using the Disease Activity Score in 28 joints. Eleven patients with RA produced indeterminate QFT-Gold test results and were thus excluded from the kappa analysis. RESULTS: Based on an induration of 10 mm in diameter as the TST cutoff value, the QFT-Gold test and TST demonstrated 75.0% agreement (kappa = 0.23) in patients with RA and 75.9% agreement (kappa = 0.19) in healthy controls. Among the 56 patients with RA who had negative TST results, 11 patients (17.2%) also yielded indeterminate QFT-Gold results. CONCLUSIONS: Our study showed poor agreement between the results of the QFT-Gold test and the TST in both RA patients and healthy controls. Based on these findings, we emphasize the importance of making clinical decisions in the diagnosis of latent tuberculosis in Koreans with or without RA.
Adult ; Aged ; Arthritis, Rheumatoid/*complications ; Female ; Healthy Volunteers ; Humans ; Interferon-gamma Release Tests/*statistics & numerical data ; Latent Tuberculosis/complications/*diagnosis ; Male ; Middle Aged ; Tuberculin Test/*statistics & numerical data

OBJECTIVETo understand the immune level of the purified protein derivative (PPD) and the present conditions of the tuberculosis among the collegians.

METHODSStandardized tuberculin testing with PPD 5 IU, social-demographic and epidemiological feature of tuberculosis were conducted in 105,239 freshmen from 33 universities in Beijing.

RESULTSThe scar rates of freshmen were 72.21%. The rates coming from cities were higher than those from countries. The scar rates were near equal for freshmen in different ages. However the rates were different evidently with the region where the students come from. The scar rates of freshmen from cities were 75.84%. The scar rates of the freshmen from countries were 62.78%. Tuberculosis infection rate of the freshmen was 51.99% and the strong positive rate was 14.63%. Tuberculosis positive rate of city students was obviously higher than that of rural ones. Tuberculosis positive rate of city students was 55.17% and the strong positive rate was 15.37%. Tuberculosis positive rate of rural students was 44.69% and the strong positive rate was 12.70%. There appeared great difference between them. Moreover, Tuberculosis infection rate was varied with age and region. The tuberculosis positive rate of students from north-east areas was the highest (72.10%, 7,746/10,744), and those come from the middle-north areas were the lowest (41.50%, 6,560/15,808). The tuberculosis positive rate (62.49%, 47,489/75,992) of the freshmen with the scar was higher than that of those without the scar (24.72%, 7,230/29,247). The tuberculosis positive rate of the freshmen having a touch with the tuberculosis cases (60.75%) was higher than those having not (51.96%).

CONCLUSIONAs students in universities are susceptible population of tuberculosis, it should be emphasized to find out tuberculosis in university and to treat them early for the purpose of preventing the episode and explosion of the disease.

Adolescent ; China ; epidemiology ; Female ; Humans ; Male ; Rural Population ; Students ; statistics & numerical data ; Tuberculin Test ; Tuberculosis, Pulmonary ; epidemiology ; Universities ; statistics & numerical data ; Urban Population ; Young Adult

This study was performed to estimate the rate of boosted reaction in the two-step tuberculin skin test (TST) and to evaluate the associated factors among military personnel of South Korea, which has an intermediate burden of tuberculosis (TB) and a routine bacille Calmette-Guerin (BCG) vaccination policy. Two-step TST was performed on 264 military personnel who did not have a history of close contact to TB. Subjects with a negative reaction to the first test of <10 mm had a second TST applied 1 week later on the other forearm. A positive result (> or =10 mm) on the initial TST was observed in 126 (48%) of the subjects. A boosted reaction on the second TST developed in 32 (23%) of the 124 subjects with a negative initial TST. In multiple logistic regression analysis, the size of the initial TST reaction was the only factor associated with a boosted reaction on the second TST. The high rate of boosted reaction among healthy adults in South Korea suggests that two-step TST should be performed to assess the baseline TST reactivity in settings with an intermediate burden of TB and routine BCG vaccination policy, especially among subjects with an initial TST reaction that is > or =5 mm.
Adult ; BCG Vaccine/*administration & dosage ; Humans ; Hypersensitivity/*diagnosis ; Incidence ; Korea/epidemiology ; Logistic Models ; Male ; Middle Aged ; *Military Personnel/statistics & numerical data ; Prevalence ; *Tuberculin Test ; Tuberculosis, Pulmonary/*diagnosis/epidemiology/prevention & control

OBJECTIVETo analyze the incidence of tuberculosis (TB) in people who were in close contact with smear-positive TB patients.

METHODSA total of 19 159 subjects, including 17 334 family members and 1825 classmates of patients, in close contact with 6653 smear-positive TB patients in Shijiazhuang city from 2007 to 2008 were observed. All the classmates were tested by purified protein derivative (PPD) test and symptom screening, and all family members were screened by symptoms. All these subjects were trained with knowledge related to TB. The ones with positive PPD test and suspected TB symptoms were further examined by chest X-ray and sputum smear microscopy, and those without any symptom were followed up monthly throughout a two year period and were examined at any time if symptoms occurred.

RESULTSA total of 281 patients with pulmonary TB were diagnosed in 2 years, including 176 family members and 105 classmates in all close contacts. The smear-positive incidences were 1466.67/100 000. The incidences for 14 - 25 years old group and more than 75 years old group were 2907.18/100 000 (83/2855) and 2650.96/100 000 (18/679), which were higher than those for other groups. Two higher incidences were related to close contact time periods of 6 months (929.07/100 000, 178/19 159) and 13 - 18 months (369.12/100 000, 70/18 964). Three highest incidences were observed in the roommates (11 384.62/100 000, 37/325), classmates (4533.33/100 000, 68/1500) and couples (1624.17/100 000, 86/5295).

CONCLUSIONCloser contact with smear-positive patients with TB may result in the higher chance of TB. Close contact for 6 months or 13 to 18 months caused more patients, and the 14 - 25 years old group and more than 75 years old group had higher incidences of TB.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Child, Preschool ; China ; epidemiology ; Cohort Studies ; Contact Tracing ; statistics & numerical data ; Female ; Humans ; Incidence ; Male ; Middle Aged ; Tuberculin Test ; Tuberculosis, Pulmonary ; epidemiology ; Young Adult

OBJECTIVETo study the situation of tuberculosis (TB) infection among the employees of the anti-TB institutions in Henan.

METHODSCross-sectional study was adopted the employees working in all municipal-level- anti-TB institutions and 40 anti-TB institutions at county-level selected randomly from 109 counties of the province were regarded as surveyed objects. Tuberculin skin test (TST) was used to test the infection with PPD.

RESULTS2153 employees accepting the TST and the positive rate was 60.6%, of which the positive rate was 66.1% among healthcare workers. Among the employees and healthcare workers, the positive rates of TST adjusted by the stratum weights between municipal-level and county-level institutions were 57.3% and 62.8% respectively with Chi-square test the analysis of multivariate logistic vegression, both positive rate and strong positive rate among healthcare workers, the employees older than 30 years of age and working in municipal-level institutions were significantly higher than those among non-healthcare workers, the employees younger than 30 years old and working in county-level institutions, respectively. There were not significant differences of positive and strong positive rates between employees with and without BCG-history, or between male employees and female employees.

CONCLUSIONProgram on TB infection control in anti-TB institutions of Henan were weak and the employees especiolly healthcare workers had a high vocational exposure.

Adult ; China ; epidemiology ; Cross-Sectional Studies ; Female ; Hospitals, Chronic Disease ; Humans ; Logistic Models ; Male ; Middle Aged ; Multivariate Analysis ; Occupational Diseases ; epidemiology ; Personnel, Hospital ; statistics & numerical data ; Population Surveillance ; Prevalence ; Tuberculin Test ; Tuberculosis ; epidemiology