|Title:||Age-Specific Cut-Offs for the Tuberculin Skin Test to Detect Latent Tuberculosis in Bcg-Vaccinated Children||Authors:||CHAN, PEI-CHUN
WU, YI- CHUN
|Keywords:||tuberculin skin test;BCG;infants and children;latent tuberculosis infection||Issue Date:||2008||Journal Volume:||v.12||Journal Issue:||n.12||Start page/Pages:||1401-1406||Source:||THE INTERNATIONAL JOURNAL OF TUBERCULOSIS AND LUNG DISEASE||Abstract:||
OBJECTIVE: To evaluate the effect of neonatal vaccination with bacille Calmette-Guérin (BCG) on tuberculin skin test (TST) reactivity over time and to define the optimal age-specific induration cut-offs to detect latent tuberculosis infection (LTBI). DESIGN: TSTs were performed on 783 children aged 3 months to 14 years who had received neonatal BCG. The estimated annual risk of LTBI was derived from TSTs administered to 2504 children aged 7 years who lacked BCG scars. Goodness-of-fit analysis was used to determine the optimal age-specific cut-off values. RESULTS: The effect of neonatal BCG on TST induration waned with age, reaching a nadir at age 6-7 years. This was followed by a rise in TST reactivity. The optimal age-specific TST cut-off values for the detection of LTBI was estimated to be respectively 21, 18, 13 and 10 mm at ages 0-1, 2-3, 4-5 and 6-7 years. There was a close correlation between these new cut-off values with the estimated risk of LTBI for the first 7 years of life (r = 0.93, P < 0.001). CONCLUSIONS: The effect of neonatal BCG on TST gradually declines over the first 7 years of life. Our proposed new age-specific TST induration cut-off values could help differentiate between response to BCG and LTBI in young children.
|Appears in Collections:||醫學系|
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