Risk factors for positive tuberculin skin test in Guinea-Bissau
Risk factors for positive tuberculin skin test in Guinea-Bissau
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DOI：
10.1097/01.ede.0000259987.46912.2b
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发表时间：
2007-05-01
期刊：
影响因子：
5.4
通讯作者：
Aaby, Peter
中科院分区：
文献类型：
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作者：
Gustafson, Per;Lisse, Ida;Aaby, Peter
背景资料：结核菌素皮肤试验是用于跟踪结核病的传播，并确定个人在需要的预防性treatment.Methods：采用病例对照研究设计，我们招募了220例涂阳肺结核病例和223个随机选择的健康社区对照比绍，几内亚，比绍，在1999-2000年。对1059例病例和921例对照者的家庭成员进行了皮肤试验。硬结≥ 10 mm视为阳性。结果：病例接触者结核菌素皮试阳性率为41%，对照接触者结核菌素皮试阳性率为22%，患病率比为1.48（95%可信区间= 1.37-1.60）。在病例接触者中，儿童和成人的皮肤试验阳性率随着年龄的增长而增加，也随着夜间接近病例而增加。在病例家庭中，卡介苗疤痕增加了成年人结核菌素皮肤试验阳性的可能性，但在其他类型的接触者中则不然。在控制接触阳性皮肤试验的患病率与年龄较大的儿童，结核病的家族史，结核菌素皮肤试验阳性的对照person.Conclusions：结核菌素皮肤试验阳性病例和控制接触的危险因素是密切相关的结核病暴露。在未暴露的个体中，有卡介苗疤痕并不会增加皮肤试验阳性的风险。结核菌素皮肤试验仍然是诊断结核病感染的有用工具。
Background: The tuberculin skin test is used for tracing of tuberculosis transmission and identifying individuals in need of prophylactic treatment.Methods: Using a case-control study design, we recruited 220 smear-positive tuberculosis cases and 223 randomly selected healthy community controls in Bissau, Guinea-Bissau, during 1999-2000. Tuberculin skin tests were performed on family members of cases and controls (n = 1059 and n = 92 1, respectively). Induration of 10 mm or greater was considered positive. Risk factors were calculated for children (< 15 years) and adults separately in multivariate logistic regression analysis.Results: The prevalence of positive tuberculin skin test was 41% in case-contacts compared with 22% in control-contacts, resulting in a prevalence ratio of 1.48 (95% confidence interval = 1.37-1.60). Positive skin tests among case-contacts increased with age for children, as well as with proximity to a case during the night, for both children and adults. A Bacille Calmette Guerin scar increased the likelihood of having a positive tuberculin skin test for adults in case households, but not in other categories of contacts. Among control-contacts the prevalence of positive skin test was associated with older age in children, history of tuberculosis in the family, and a positive tuberculin skin test of the control person.Conclusions: Risk factors for a positive tuberculin skin test among case- and control-contacts are closely related to tuberculosis exposure. Having a BCG scar did not increase the risk of positive skin test in unexposed individuals. Tuberculin skin testing remains a useful tool for diagnosing tuberculosis infection.