Use of purified protein derivative to assess the risk of infection in children in close contact with adults with tuberculosis in a population with high Calmette-Guerin bacillus coverage
Use of purified protein derivative to assess the risk of infection in children in close contact with adults with tuberculosis in a population with high Calmette-Guerin bacillus coverage
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DOI：
10.1097/00006454-200111000-00011
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发表时间：
2001-11-01
影响因子：
3.6
通讯作者：
Cuevas, LE
中科院分区：
文献类型：
--
作者：
Almeida, LMD;Barbieri, MA;Cuevas, LE
设置.在巴西东北部塞尔吉佩Aracaju参比中心就诊的15岁以下成年结核病（TB）患者的家庭接触者。评估最近暴露于TB的高卡介苗（BCG）覆盖率儿童中纯化蛋白衍生物（PPD）的使用和感染频率。对141名15岁以下暴露的家庭接触者和506名未暴露的社区对照者进行的横断面研究。对儿童进行指标病例暴露程度、卡介苗接种和烧灼感的检查和评估，并进行PPD试验。与对照组相比，暴露组儿童年龄较小，接种时间较晚（P < 0.05）。卡介苗接种率分别为95.6%和97.4%，但有烧灼感的比例分别为80.9%和88.5%（P < 0.05）。暴露儿童的瘢痕大小较小（中位数分别为4.5和7 mm; P < 0.05）。儿童的年龄z评分和身高低于国家卫生统计中心的标准。接触组儿童年龄别体重z评分低于对照组（P < 0.05）。67名（47.5%）暴露儿童和18名（3.6%）对照儿童的PPD读数> 10 mm。阳性和硬结大小随年龄增加而增加，尽管这仅在对照组中有意义。BCG疤痕的存在与PPD阳性无关。暴露程度是PPD阳性的重要因素; 66（60.6%）的109名儿童与密切接触阳性相比，1（3.1%）的32个较少的亲密接触。密切接触者的PPD硬结也大于限制接触者和对照者（分别为16.3、11和9.4 mm; P
Setting. Household contacts < 15 years of age of adults with tuberculosis (TB) attending a reference center in Aracaju, Sergipe, Northeast Brazil.Objective. To assess the use of purified protein derivative (PPD) and frequency of infection in children with high Calmette-Guerin bacillus (BCG) coverage who were recently exposed to TB.Design. Cross-sectional study of 141 exposed household contacts < 15 years of age and 506 nonexposed neighborhood controls. Children were examined and assessed for degree of exposure to index cases, BCG vaccination and sear and were tested with PPD.Results. Exposed children were younger and less up to date in their vaccination schedule than controls (P < 0.05). BCG had been given to 95.6% of exposed children and 97.4% of controls, but only 80.9% of exposed vs. 88.5% of controls had a sear (P < 0.05). Scar sizes of exposed children were smaller (medians, 4.5 and 7 mm, respectively; P < 0.05). Children had lower weight for age z scores and height than the National Center for Health Statistics standards. Exposed children had lower weight for age z scores than controls (P < 0.05). Sixty-seven (47.5%) exposed children and 18 (3.6%) controls had PPD readings of > 10 mm. Positivity and induration sizes increased with age, although this was significant only in the controls. The presence of a BCG scar was not associated with having a positive PPD. The degree of exposure was an important factor for PPD positivity; 66 (60.6%) of the 109 children with close exposure were positive compared with 1 (3.1%) of 32 with less intimate exposure. PPD indurations among close contacts were also larger than those with restricted exposure and controls (16.3, 11 and 9.4 mm, respectively; P