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PHRP : Osong Public Health and Research Perspectives

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Original Articles
Estimating Tuberculin Skin Test Reactions among Children and Teenagers Who Received the Bacillus Calmette-Guerin Vaccination at Birth: A Meta-analysis
Mohammad Sadegh Rezai, Siavosh Abedi, Mahdi Afshari, Mahmood Moosazadeh
Osong Public Health Res Perspect. 2017;8(1):3-10.   Published online February 28, 2017
DOI: https://doi.org/10.24171/j.phrp.2017.8.1.02
  • 2,557 View
  • 24 Download
  • 2 Citations
AbstractAbstract PDF
Objectives

Tuberculin skin reaction size is one indicator of bacillus Calmette-Guérin (BCG) vaccine efficacy and a way to diagnose latent infection. Several primary studies have examined this issue. Combining the results of these studies using a meta-analysis will provide reliable evidence regarding this indicator for policymakers. This study aimed to estimate the total frequency of different tuberculin skin test reactions among Iranian children and teenagers who received the BCG vaccination at birth.

Methods

National and international databanks were searched using relevant keywords. After the search strategy was restricted and duplicates were excluded, the titles and abstracts of the remaining papers were screened. All included studies included healthy children who received the BCG vaccine without confirmed tuberculosis exposure. Heterogeneity of the results was assessed using the Cochrane test and I2 index showed the random effects model as the best model for estimating the pooled results.

Results

We combined the results of 14 primary studies including purified protein derivative reaction test measures of 26,281 Iranian children. The frequencies (95% confidence intervals) of the reactions were 8.5% (6.2–10.8) for patients with a reaction size ≥ 10 mm, 29.9% (22.3–37.4) for a reaction size of 5–9 mm, and 60% (48.9–71.1) for a reaction size < 5 mm.

Conclusion

Our study showed that large numbers of Iranian children and teens have no positive BCG vaccine reaction and a considerable number of children have been exposed to Mycobacterium tuberculosis.

Results of Tuberculosis Contact Investigation in Congregate Settings in Korea, 2013
Yunhyung Kwon, So Jung Kim, Jieun Kim, Seol-yi Kim, Eun Mi Song, Eun Jung Lee, Yun Choi, Yejin Kim, Byoung ok Lim, Da Sul Kim, Duksun Choi, Hye Sung Kim, Ji Eun Park, Ji-eun Yun, Jin A. Park, Jong Rak Jung, Joo-kyoung Kim, Sang Hee Kang, Seo Yean Hong, Seung Jae Lee, Soo Jin Park, Sun Hwa Park, Sunhye Yoon, Yoonsun Kim, Yunjeong Choi, Yun Jeong Seo, Yul A Seo, Jiseon Park, Minhee Sung, Minjang Shin, Hyunjin Son, Yeonkyeng Lee, Unyeong Go, Geun-Yong Kwon
Osong Public Health Res Perspect. 2014;5(Suppl):S30-S36.   Published online December 31, 2014
DOI: https://doi.org/10.1016/j.phrp.2014.10.010
  • 1,937 View
  • 17 Download
  • 5 Citations
AbstractAbstract PDF
Objectives
This study aimed to check the status of the contact investigation in congregate settings to eradicate tuberculosis (TB) in the Republic of Korea.
Methods
The “Integrated System for Disease and Public Health Management” is used for care and follow-up for patients and contacts of TB. We downloaded data for contact investigations conducted from January to December 2013.
Results
A total of 1,200 contact investigations in congregate settings were carried out by 25 field investigators in 2013. We performed the status of contact investigation, TB, and LTBI rate by age, accept rate of LTBI treatment, and complete rate of LTBI treatment during 2013. A total of 1,547 index TB patients, 149,166 contacts, and 259 additional TB patients were found through the investigation. Kindergartens showed the highest LTBI rate, 19.8%, among educational facilities. The second highest was in elementary schools and the subtotal LTBI rate of educational facilities was 7.8%. Social welfare/correctional facilities and workplaces showed relatively high LTBI rates of 23.8% and 23.6%, respectively. By age, individuals >35 years showed the highest LTBI rate, followed by those aged 0–4 years, 30–34 years, and 5–9 years, with rates of 18.1%, 16.4%, and 15.4% respectively. When comparing the tuberculin skin test (TST) positive conversion ratio by facility, middle school and high school were relatively high compared to the others. The accept rate of LTBI treatment in the workplace was lowest at 63% and the complete rate in elementary schools was lowest at 76.5%.
Conclusion
TB contact investigation is considered as a meaningful strategy for preventing TB outbreaks in congregate settings and decreasing the prevalence of TB in young people. Results of this study could be used to establish the LTBI management policy.
The Usefulness of the Tuberculosis Skin Test and the Interferon-gamma Release Assay in the Diagnosis of Latent Tuberculosis Infection in South Korea
Ju Young Jang, In Won Park, Byoung Whui Choi, Jae Chol Choi
Osong Public Health Res Perspect. 2014;5(Suppl):S18-S23.   Published online December 31, 2014
DOI: https://doi.org/10.1016/j.phrp.2014.10.009
  • 1,661 View
  • 19 Download
  • 3 Citations
AbstractAbstract PDF
Objectives
South Koreans receive the bacillus Calmette-Guerin (BCG) vaccination, which influence the result of the tuberculin skin test (TST); however, only a few studies have described the usefulness of the TST and interferon-γ release assay (IGRA) for diagnosing latent TB infection (LTBI). Therefore, our aim was to determine the usefulness of the TST and IGRA for diagnosing LTBI in a household contacts investigation.
Methods
We reviewed the 329 household contacts who visited Chung-Ang University Hospital (Seoul, Korea) from May 1, 2011 to February 28, 2014. To evaluate the effectiveness of TST and IGRA for the diagnosis of LTBI, we examined the concordance rate between the two tests, based on age. We also evaluated the risk factors for LTBI.
Results
The concordance rate between the two tests in individuals 0–24 years, 25–54 years, and over 55 years were 82.6% (κ = 0.64, p < 0.01), 68.9% (κ = 0.40, p < 0.01), and 68.4% (κ = 0.35, p < 0.01), respectively. The ratio of positive TST to negative IGRA was higher in individuals 25–44 years old, whereas the ratio of negative TST to positive IGRA was higher in individuals older than 55 years old. Based on the TST, the risk factor for LTBI was a cavity (p < 0.01). When using IGRA, the risk factors were contact time (p = 0.04) and age over 55 years old (p = 0.02).
Conclusion
The concordance rate between TST and IGRA was not good after the age of 25 years. The IGRA test reflects the known risk factors more exactly.

PHRP : Osong Public Health and Research Perspectives