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José Raúl NS, Joshua SV, Adriana VG, Eva GD, la Torre-Gutiérrez Hector D, Liz Jovanna MN, Alejandro Ernesto MH, Juan Luis MG. Tuberculin skin test versus QuantiFERON-TB gold in-tube for latent tuberculosis screening in people living with HIV in a resource-limited setting. Int J STD AIDS 2023; 34:108-113. [PMID: 36382960 DOI: 10.1177/09564624221137969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To compare QuantiFERON-TB Gold-in-Tube (QFT) and tuberculin skin test (TST) in the diagnosis of latent tuberculosis infection (LTBI) among people living with HIV (PLWHIV). METHODS A cross-sectional study was carried out between 2017-2018. Tuberculin skin test and QFT were performed and their concordance was measured. The gold standard for LTBI was defined as positivity to any of the tests. A logistic regression model was carried out to predict the QFT result in patients with a negative TST. RESULTS A total of 510 PLWHIV were included, with 409 (80.2%) being male. The mean age of the patients was 41.3 ± 11.8 years. The median time since HIV diagnosis was 5 years (IQR 2-10), with a median CD4+ count of 541 (IQR 340-757) cells/mm3. Overall, 20 patients had an isolated TST+, 22 an isolated QFT+ and 15 had both positive. Concordance between tests showed a kappa coefficient of .37. Overcrowding was the only predictor for a positive QFT after a negative TST (p = .003). CONCLUSION There was fair agreement between tests in PLWHIV. In conditions of limited access to QTF, a TST-based strategy could be considered, with sequential use of QTF in high-risk patients with a negative result, especially those who live in overcrowded conditions.
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Affiliation(s)
| | | | | | - Gutiérrez-Delgado Eva
- 126671Ambulatory Center for the Prevention and Care of AIDS and Sexually Transmitted Diseases, Leon, Mexico
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Plascencia Hernández A, González Sánchez RM, Hernández Cañaveral II, Luévanos Velázquez A, Martínez Arce PA, González Díaz A, Sandoval Díaz M, de Armas Rodríguez Y, González Ochoa E, Pérez Gómez HR. A prevalence study in Guadalajara, Mexico, comparing tuberculin skin test and QuantiFERON-TB Gold In-Tube. PLoS One 2022; 17:e0264982. [PMID: 35271625 PMCID: PMC8912134 DOI: 10.1371/journal.pone.0264982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Accepted: 02/21/2022] [Indexed: 11/19/2022] Open
Abstract
Background Tuberculosis (TB) is a prevalent disease throughout the world. The extent of TB illness in childhood is not clear; recent data shows that 10–20% of the cases are found in children under 15 years old. In 2017, 1 million children developed the disease, of which 9% were co-infected with HIV. Methods A cross-sectional study that analyzed 48 children diagnosed with HIV-infection in Guadalajara, Mexico. The tuberculin skin test (TST) and QuantiFERON-TB Gold In-Tube test (QFT) were performed and compared to diagnose latent TB infection (LTBI). Results The average age was 9 years old (± 4), with an age range of 1–16 years; the 6-12-year-old group predominated with 50% of cases. 27 patients (56%) were male; 83% had received the BCG vaccination and 23% had a history of being contacts of TB cases. In the study, 40 patients (83%) were without immunosuppression; seven (15%) with moderate immunosuppression, and only one patient had severe immunodeficiency. Overall, 3 of the 48 children (6.2%) had a positive TST, while 8 out of 48 (16.6%) had a positive QFT. The concordance between the two tests was 89.6% (43/48) with Kappa = 0.5 (95% CI, 0.14–0.85). Conclusions The QFT test represents an opportunity in the diagnosis of LTBI, particularly in pediatric HIV- patients. This is the first study that compares the two tests (TST and QFT) in children with HIV-infection in Guadalajara, Mexico.
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Affiliation(s)
- Arturo Plascencia Hernández
- University Center for Health Sciences (Centro Universitario de Ciencias de la Salud), University of Guadalajara, Guadalajara, México
- “Fray Antonio Alcalde” Civil Hospital of Guadalajara, Guadalajara, México
| | - Rodrigo M. González Sánchez
- University Center for Health Sciences (Centro Universitario de Ciencias de la Salud), University of Guadalajara, Guadalajara, México
- “Fray Antonio Alcalde” Civil Hospital of Guadalajara, Guadalajara, México
| | - Iván I. Hernández Cañaveral
- University Center for Health Sciences (Centro Universitario de Ciencias de la Salud), University of Guadalajara, Guadalajara, México
| | - Antonio Luévanos Velázquez
- University Center for Health Sciences (Centro Universitario de Ciencias de la Salud), University of Guadalajara, Guadalajara, México
- “Fray Antonio Alcalde” Civil Hospital of Guadalajara, Guadalajara, México
| | - Pedro A. Martínez Arce
- University Center for Health Sciences (Centro Universitario de Ciencias de la Salud), University of Guadalajara, Guadalajara, México
- “Fray Antonio Alcalde” Civil Hospital of Guadalajara, Guadalajara, México
| | | | | | | | | | - Héctor Raúl Pérez Gómez
- University Center for Health Sciences (Centro Universitario de Ciencias de la Salud), University of Guadalajara, Guadalajara, México
- * E-mail:
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Medina-Macías O, Stoesslé P, Perales-Rendón LE, Moreno-Cuevas JE, González-Salazar F. Latent tuberculosis in migrants travelling through the northeast regions of Mexico. J Clin Tuberc Other Mycobact Dis 2020; 21:100194. [PMID: 33195823 PMCID: PMC7644743 DOI: 10.1016/j.jctube.2020.100194] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Background Latent tuberculosis infection (LTBI) affects nearly a quarter of the global population. Public health interventions aimed at interrupting tuberculosis transmission do not routinely include systematic screening of migrant populations for LTBI in Mexico, nor other high-income countries. However, early detection and treatment of LTBI in immigrant populations from high-burden countries are recommended by the World Health Organization. Objective The objective of this study was to determine the proportion of migrants with LTBI in shelters in northeastern Mexico. Methods In this cross-sectional study, blood samples were obtained from 455 migrants living in shelters in northeastern Mexico during January 2017 to October 2019. LTBI was diagnosed using the QuantiFERON®-TB Gold Plus test. Results Most of the migrants evaluated in this study were from Honduras; ∼86% were male; the average age was 29 ± 10 years. LTBI was identified in 18.4% of those from Central America. Migrants from El Salvador and Nicaragua were more likely to have LTBI than those from Honduras or Guatemala. Overweight or obese persons and older persons had a higher prevalence of LTBI. We detected no significant differences with respect to LTBI when the results were compared based on gender, education, or marital status. Conclusion The LTBI rates amongst migrants from Central America recently screened in shelters in northeastern Mexico appears to be relatively low given recent estimates of LTBI prevalence in Mexico.
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Affiliation(s)
- Obed Medina-Macías
- División de Ciencias de La Salud, Departamento de Ciencias Básicas, Universidad de Monterrey, Monterrey, Mexico
| | - Philippe Stoesslé
- Departamento de Ciencias Sociales, Universidad de Monterrey, Monterrey, Mexico
| | - Leonardo E Perales-Rendón
- Centro de Investigaciones Biomédicas Del Noreste, Instituto Mexicano Del Seguro Social, Monterrey, Mexico
| | - Jorge E Moreno-Cuevas
- División de Ciencias de La Salud, Departamento de Ciencias Básicas, Universidad de Monterrey, Monterrey, Mexico
| | - Francisco González-Salazar
- División de Ciencias de La Salud, Departamento de Ciencias Básicas, Universidad de Monterrey, Monterrey, Mexico.,Centro de Investigaciones Biomédicas Del Noreste, Instituto Mexicano Del Seguro Social, Monterrey, Mexico
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Arcoverde MAM, Berra TZ, Alves LS, Santos DTD, Belchior ADS, Ramos ACV, Arroyo LH, Assis ISD, Alves JD, Queiroz AARD, Yamamura M, Palha PF, Neto FC, Silva-Sobrinho RA, Nihei OK, Arcêncio RA. How do social-economic differences in urban areas affect tuberculosis mortality in a city in the tri-border region of Brazil, Paraguay and Argentina. BMC Public Health 2018; 18:795. [PMID: 29940908 PMCID: PMC6019811 DOI: 10.1186/s12889-018-5623-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2017] [Accepted: 05/29/2018] [Indexed: 11/18/2022] Open
Abstract
Background The World Health Organization (WHO) launched the “End TB Strategy”, which aims to reduce tuberculosis (TB) mortality by 95% by 2035, Brazil has made a commitment to this, however, one challenge is achieving the goal in the border region, where the TB situation is more critical. The proposal was to analyse the spatial mortality due to TB and its socio-economic determinants in the general population, around the border areas of Brazil, Paraguay and Argentina, as well as the temporal trend in this region. Method This ecological study considered the cases of TB deaths of residents of Foz do Iguaçu (BR), with its units of analysis being the census sectors. The standardized mortality rate was calculated for each area. Socioeconomic variables data were obtained from the 2010 Demographic Census of the Brazilian Institute of Geography and Statistics (IBGE). The scan statistic was applied to calculate the spatial relative risk (RR), considering a 95% confidence interval (CI). Spatial dependence was analysed using the Global Bivariate Moran I and Local Bivariate Moran I (LISA) to test the relationship between the socioeconomic conditions of the urban areas and mortality from TB. Analysis of the temporal trend was also performed using the Prais-Winsten test. Results A total of 74 cases of TB death were identified, of which 53 (71.6%) were male and 51 (68.9%) people of white skin colour. The mortality rate ranged from 0.28 to 22.75 cases per 100,000 inhabitants. A spatial relative risk area was identified, RR = 5.07 (95% CI 1.79–14.30). Mortality was associated with: proportion of people of brown skin colour (I: 0.0440, p = 0.033), income (low income I: − 0.0611, p = 0.002; high income I: − 0.0449, p = 0.026) and density of residents (3 and 4 residents, I: 0.0537, p = 0.007; 10 or more residents, I: − 0.0390, p = 0.035). There was an increase in the mortality rate in people of brown skin colour (6.1%; 95% CI = 0.029, 0.093). Conclusion Death due to TB was associated with income, race resident density and social conditions. Although the TB mortality rate is stationary in the general population, it is increasing among people of brown skin colour.
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Affiliation(s)
- Marcos Augusto Moraes Arcoverde
- Nursing College of Ribeirão Preto, University of São Paulo, São Paulo, Brazil. .,State University of West Paraná, Avenida Paraná, 1610, Foz do Iguaçu, Paraná, 85863-720, Brazil.
| | - Thais Zamboni Berra
- Nursing College of Ribeirão Preto, University of São Paulo, São Paulo, Brazil
| | - Luana Seles Alves
- Nursing College of Ribeirão Preto, University of São Paulo, São Paulo, Brazil
| | | | | | | | | | | | | | | | - Mellina Yamamura
- Nursing College of Ribeirão Preto, University of São Paulo, São Paulo, Brazil
| | | | | | | | - Oscar Kenji Nihei
- State University of West Paraná, Avenida Paraná, 1610, Foz do Iguaçu, Paraná, 85863-720, Brazil
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Teklu T, Legesse M, Medhin G, Zewude A, Chanyalew M, Zewdie M, Wondale B, Haile-Mariam M, Pieper R, Ameni G. Latent tuberculosis infection and associated risk indicators in pastoral communities in southern Ethiopia: a community based cross-sectional study. BMC Public Health 2018; 18:266. [PMID: 29454325 PMCID: PMC5816385 DOI: 10.1186/s12889-018-5149-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2017] [Accepted: 02/02/2018] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Research pertaining to the community-based prevalence of latent tuberculosis infection (LTBI) is important to understand the magnitude of this infection. This study was conducted to estimate LTBI prevalence and to identify associated risk factors in the Omo Zone of Southern Ethiopia. METHODS A community-based cross-sectional study was conducted in six South Omo districts from May 2015 to February 2016. The sample size was allocated to the study districts proportional to their population sizes. Participants were selected using a multi-stage sampling approach. A total of 497 adult pastoralists were recruited. Blood samples were collected from the study participants and screened for LTBI using a U.S. Food and Drug Administration approved interferon-gamma release assay (IGRA). Logistic regression was used to model the likelihood of LTBI occurrence and to identify risk factors associated with LTBI. RESULTS The prevalence of LTBI was 50.5% (95% CI: 46%, 55%) with no significant gender difference (49.8% among males versus 51.2% among females; Chi-square (χ2) = 0.10; P = 0.41) and marginally non-significant increasing trends with age (44.6% among those below 24 years and 59.7% in the age range of 45-64 years; χ2 = 6.91; P = 0.075). Being residence of the Dasanech District (adjusted odds ratio, AOR = 2.62, 95% CI: 1.30, 5.28; P = 0.007) and having a habit of eating raw meat (AOR = 2.89, 95% CI: 1.09, 7.66; P = 0.033) were significantly associated with an increased odds of being positive for LTBI. A large family size (size of 5 to 10) has significant protective effect against associated a reduced odds of being positive for LTBI compared to a family size of below 5 (AOR = 0.65, 95% CI: 0.42, 0.99; P = 0.045). CONCLUSIONS A high prevalence of LTBI in the South Omo Zone raises the concern that elimination of TB in the pastoral communities of the region might be difficult. Screening for and testing individuals infected with TB, independent of symptoms, may be an effective way to minimize the risk of disease spread.
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Affiliation(s)
- Takele Teklu
- Aklilu Lemma Institute of Pathobiology (ALIPB), Addis Ababa University, P O Box 1176, Addis Ababa, Ethiopia
- Department of Immunology and Molecular Biology, College on Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Mengistu Legesse
- Aklilu Lemma Institute of Pathobiology (ALIPB), Addis Ababa University, P O Box 1176, Addis Ababa, Ethiopia
| | - Girmay Medhin
- Aklilu Lemma Institute of Pathobiology (ALIPB), Addis Ababa University, P O Box 1176, Addis Ababa, Ethiopia
| | - Aboma Zewude
- Aklilu Lemma Institute of Pathobiology (ALIPB), Addis Ababa University, P O Box 1176, Addis Ababa, Ethiopia
| | - Mahlet Chanyalew
- Aklilu Lemma Institute of Pathobiology (ALIPB), Addis Ababa University, P O Box 1176, Addis Ababa, Ethiopia
| | - Martha Zewdie
- Armauer Hansen Research Institute, AHRI, PO Box 1005, Addis Ababa, Ethiopia
| | - Biniam Wondale
- Aklilu Lemma Institute of Pathobiology (ALIPB), Addis Ababa University, P O Box 1176, Addis Ababa, Ethiopia
- Department of Biology, College of Natural Sciences, Arbaminch University, Arbaminch, Ethiopia
| | - Milkessa Haile-Mariam
- Aklilu Lemma Institute of Pathobiology (ALIPB), Addis Ababa University, P O Box 1176, Addis Ababa, Ethiopia
- Department of Veterinary Laboratory, College of Agriculture, Ambo University, Guder, Ethiopia
| | | | - Gobena Ameni
- Aklilu Lemma Institute of Pathobiology (ALIPB), Addis Ababa University, P O Box 1176, Addis Ababa, Ethiopia
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Osuchukwu O, Nuῆez M, Packard S, Ehiri J, Rosales C, Hawkins E, Gerardo Avilés JG, Gonzalez-Salazar F, Oren E. Latent Tuberculosis Infection Screening Acceptability among Migrant Farmworkers. INTERNATIONAL MIGRATION 2017. [DOI: 10.1111/imig.12275] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Obiyo Osuchukwu
- Department of Health Promotion Sciences; University of Arizona; Tucson
| | | | - Samuel Packard
- Department of Epidemiology & Biostatistics; University of Arizona; Tucson
| | - John Ehiri
- Department of Health Promotion Sciences; University of Arizona; Tucson
| | - Cecilia Rosales
- Department of Health Promotion Sciences; University of Arizona; Tucson
| | | | | | | | - Eyal Oren
- Department of Epidemiology & Biostatistics; University of Arizona; Tucson
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Oren E, Fiero MH, Barrett E, Anderson B, Nuῆez M, Gonzalez-Salazar F. Detection of latent tuberculosis infection among migrant farmworkers along the US-Mexico border. BMC Infect Dis 2016; 16:630. [PMID: 27809805 PMCID: PMC5096297 DOI: 10.1186/s12879-016-1959-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2016] [Accepted: 10/25/2016] [Indexed: 12/22/2022] Open
Abstract
Background Migrant farmworkers are among the highest-risk populations for latent TB infection (LTBI) in the United States with numerous barriers to healthcare access and increased vulnerability to infectious diseases. LTBI is usually diagnosed on the border using the tuberculin skin test (TST). QuantiFERON-TB Gold In-Tube (QFT-GIT) also measures immune response against specific Mycobacterium tuberculosis antigens. The objective of this study is to assess the comparability of TST and QFT-GIT to detect LTBI among migrant farmworkers on the border, as well as to examine the effects of various demographic and clinical factors on test positivity. Methods Participants were recruited using mobile clinics on the San Luis US-Mexico border and tested with QFT-GIT and TST. Demographic profiles and clinical histories were collected. Kappa coefficients assessed agreement between TST and QFT-GIT using various assay cutoffs. Logistic regression examined factors associated with positive TST or QFT-GIT results. Results Of 109 participants, 59 of 108 (55 %) were either TST (24/71, 34 %) or QFT-GIT (52/106, 50 %) positive. Concordance between TST and QFT-GIT was fair (71 % agreement, ĸ = 0.38, 95 % CI: 0.15, 0.61). Factors associated with LTBI positivity included smoking (OR = 1.26, 95 % CI–1.01–1.58) and diabetes/high blood sugar (OR = 0.70, 95 % CI = 0.51–0.98). Discussion Test concordance between the two tests was fair, with numerous discordant results observed. Greater proportion of positives detected using QFT-GIT may help avoid LTBI under-diagnosis. Assessment of LTBI status on the border provides evidence whether QFT-GIT should replace the TST in routine practice, as well as identifies risk factors for LTBI among migrant populations. Electronic supplementary material The online version of this article (doi:10.1186/s12879-016-1959-3) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- E Oren
- Department of Epidemiology & Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, 1295 N. Martin Ave., P.O. Box 245211, Tucson, AZ, 85724, USA.
| | - M H Fiero
- Department of Epidemiology & Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, 1295 N. Martin Ave., P.O. Box 245211, Tucson, AZ, 85724, USA
| | - E Barrett
- Department of Epidemiology & Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, 1295 N. Martin Ave., P.O. Box 245211, Tucson, AZ, 85724, USA
| | - B Anderson
- Department of Epidemiology & Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, 1295 N. Martin Ave., P.O. Box 245211, Tucson, AZ, 85724, USA
| | - M Nuῆez
- Yuma County Health Services District, 2200 W 28th St, Yuma, AZ, 85364, USA
| | - F Gonzalez-Salazar
- Mexican Social Security Institute, Juárez, México City, Mexico.,University of Monterrey, Avenida Ignacio Morones Prieto 4500 Pte., Jesús M. Garza, 66238, San Pedro Garza García, NL, Mexico
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