The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease · 2008
Age-specific cut-offs for the tuberculin skin test to detect latent tuberculosis in BCG-vaccinated children.
СтатьяПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
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Chan P-C, Chang L-Y, Wu Y-C, Lu C-Yi, Kuo H-S, Lee C-Y, Huang L-M, Chen C-J
Аннотация
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.
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.