Tuberculin Test Results Research Articles

Differentiation of Bovine Tuberculosis and Paratuberculosis Infections with Antemortem Diagnostic Methods

In this study, based on the results of tuberculin skin tests (Bovine and Avian PPD) used in the antemortem diagnosis and differentiation of Bovine Tuberculosis, the animals in the farms with suspected Tuberculosis were serologically examined to diagnose Paratuberculosis infection and fecal bacterioscopy was performed. In addition, it was aimed to obtain data that will contribute to the eradication studies of Bovine Tuberculosis disease by comparing the antemortem diagnostic methods of Bovine Tuberculosis disease, which is endemic in Türkiye and by determining the sensitivity and specificity values of the interferon gamma (IFN-γ) test. In this context, intradermal tuberculin test was applied to 423 cattle with suspected Tuberculosis in a total of 5 dairy cattle farms, one each from Çankırı, Çorum, Ankara, Eskişehir and Konya regions, and this test was determined as the gold standard method and the sensitivity and specificity of the IFN-γ test were determined as 86% and 97%, respectively. For the diagnosis of Paratuberculosis infection, antibody ELISA, fecal bacterioscopy and IFN-γ ELISA were performed on these animals and the prevalence of these tests were 10.4%, 5.44% and 4.96% respectively and 4 (0.95%) of the cattle were positive for each of the diagnostic methods for Map infection. As a result, it was concluded that IFN-γ test, which gives similar results to intradermal tuberculin test results, can also be used in the antemortem diagnosis of Bovine Tuberculosis. Also, in the comparative intradermal tuberculin test for the diagnosis of Tuberculosis infection, avian PPD positive animals were found to play a decisive role in the detection of nonspecific reactions or Paratuberculosis infected animals, supported by other tests used for the diagnosis of Paratuberculosis.

Miliary tuberculosis mimicking COVID-19 multisystemic inflammatory syndrome in children

Miliary tuberculosis (TB) is a severe form of disseminated TB. In pediatrics, many cases are missed because the symptomatology of TB mimics common childhood diseases.We present the case of a 6-year-old girl with no remarkable history who had recurrent fever for 3 months. She was initially diagnosed with, and treated for, refractory multisystem inflammatory syndrome in children (MIS-C). When the study was extended to other differential diagnoses, thoraco-abdominopelvic computed tomography revealed miliary pulmonary nodules in addition to lymph nodes and spleen lesions. Magnetic resonance imaging of the brain revealed multiple tuberculomas. The tuberculin test results were positive. The course of the disease was favorable under quadruple therapy.

BCG vaccine safety in COVID-19 convalescent adults: BATTLE a randomized controlled trial

IntroductionThe safety of BCG revaccination is uncertain and there is no data on its use in patients with COVID-19. MethodsCOVID-19 convalescent adults confirmed by SARS-CoV-2 RT-PCR in South-America were 1:1 randomized in the first 14 days of symptoms to BCG intradermal vaccine or placebo and evaluated for adverse events on days 7, 14, 21, and beyond 40 days. Clinical Trial Registration: NCT04369794. Results151 placebo and 148 BCG patients were included in the final analysis, with an average age of 40.7 years. No severe adverse event to BCG was reported. On day 7, 130 (87.8%) of the BCG recipients had local reaction, average size of 10.6 ± 6.4 mm, compared to only 2 (1.3%) placebos. Lesions gradually shrunk in size (mean 10.5 mm, 9.7 mm, and 6.8 mm at 14, 21, and beyond 40 days, respectively. The number of symptoms in any of the visits was not different between groups, and anosmia resolved earlier (25.7% vs. 37.1% at 7 days, OR = 1.70, 1.01–2.89, p = 0.035) in the BCG recipients. ConclusionThe BCG revaccination is safe in convalescent COVID-19 adults of a tuberculosis endemic region, regardless of tuberculin or IGRA test results. Local adverse events were similar though occurred earlier to that previously reported in children.

Frequency of Latent Tuberculosis Infection in Patients with Type 2 Diabetes referred to Shahid Rahimi Hospital in Khorramabad City with Tuberculin Skin Test in 2018-2020

Introduction: Tuberculosis is the leading cause of death from infectious diseases worldwide. Diabetes has been suggested as an important risk factor for tuberculosis. To date, few studies have examined the association between diabetes and tuberculosis. In this study, the prevalence of latent tuberculosis in diabetic patients was investigated.
 Methods: In this study, 195 patients with type 2 diabetes were studied in a cross-sectional study to diagnose latent tuberculosis infection with a tuberculin skin test. Individuals with symptoms of active tuberculosis were excluded from the study, and individuals with a positive tuberculin test were evaluated for active tuberculosis by chest x-ray. For analyzing the data, SPSS software version 16 was run, a t-test was used to analyze quantitative variables, and for qualitative variables, Chi-square was applied. The significance level of 0.05 was considered for all the results.
 Results: Out of 195 diabetic patients, 115 patients were referred for tuberculin test results. 43 out of 115 patients (37.39%) had an induration diameter greater than or equal to 5 mm, 29 patients (25.21%) had an induration diameter greater than or equal to 8 mm, and 3 patients (2.61%) had an induration diameter greater than or equal to 10 mm (Positive tuberculin test) (p>0.05).
 Conclusion: False tuberculin skin test results can hide the true prevalence of latent tuberculosis infection. The sensitivity of the tuberculin test decreases in immunocompromised patients and leads to limitations in assessing the prevalence of latent tuberculosis infection. Although not enough information was available in this study to establish a significant association between diabetes and latent tuberculosis infection, further studies will help to investigate this association.

A case of a 4-year-old boy with difficult-to-diagnose skin infection with nontuberculous mycobacteria

Nontuberculous mycobacteria infections have become increasingly common in recent years and have even been confirmed in children. In addition to other organs, they can even affect the skin; nevertheless, in children lymphadenitis is the most common manifestation of the infection. The diagnosis of mycobacterial skin infection is based on patient history, clinical picture, histopathological changes, and tuberculin test result. Evidence of the causative agent in the lesion is confirmed with cultivation and PCR, two of the main tests that help determine the type of the causative mycobacteria. Here we report the case of a 4-year-old boy that presented with a few pink-to-livid papules and one plaque with a central crust on the skin of the left knee and an enlarged popliteal lymph node, highly suspicious of nontuberculous mycobacteria infection. Among the laboratory results, only a positive QuantiFERON and Mantoux test stood out. In addition, in the histopathological report, superficial and deep inflammatory elements were described, which could be due to an infection with nontuberculous mycobacteria. Despite negative cultivation and PCR, in agreement with a pediatric pulmonologist we decided to introduce antibiotic therapy for 6 months. Treatment was successful, we achieved regression of the skin lesions, and lymphadenitis was no longer present.

PCR investigation of the vertical transmission of Mycobacterium bovis in Montbéliarde cattle in Gonbad, northeast of Iran

Bovine tuberculosis is an important global zoonosis. The causative agent of the disease is Mycobacterium bovis, belonging to the Mycobacterium tuberculosis complex. This study aimed to identify vertical transmission of Mycobacterium bovis in tuberculin positive pregnant dairy cows referred to the slaughterhouse and commercial sperm used to inseminate them in Gonbad, Gorgan province, Iran, by PCR assay. From March to September 2016, one thousand and seven hundred artificially inseminated cows were subjected to the tuberculin test; then, tuberculin positive cows were referred to the Gonbad slaughterhouse. Samples containing milk, lymph node, placenta, foetal abomasal fluid, and amniotic fluid were prepared from all affected cows and stored at -80 °C until analysis. Bacterial DNA was extracted from all specimens by a commercial kit. Detection was performed by amplifying pncATB gene using special primers via the polymerase chain reaction method. Results of tuberculin test revealed 144 positive cases (8.47%). PCR results for 48 milk samples, 120 biopsy samples, 63 samples of foetuses showed 9, 93 and 43 positive cases, respectively which all belonged to tuberculin positive samples. No positive sperm samples were identified. It was concluded that the infection rate with M. bovis in Montbéliarde cattle was high and also, that vertical transmission was not seen.

Diagnosis of goat tuberculosis using tuberculinization and molecular techniques

Tuberculosis is an infectious, chronic, and worldwide disease. It has been known since the beginning of humanity and still negatively influences public health and livestock, especially, in Brazil, in the northeast. Etiologic agents are the mycobacteria of the Mycobacterium tuberculosis complex, which is the most important in mammals’ involvement. The state of Bahia has 68.7% of its territory located in the semiarid region and holds the largest goat herd in the country. Goat breeding is a social and economic activity that adds value to this region. Up to the present, data on goat tuberculosis is unknown in this state. Thus, this study seeks data on tuberculosis prevalence in goats in a semiarid region of Bahia by using the comparative tuberculin test and multiplex polymerase chain reaction (PCR). A total of 600 adult animals of both sexes were evaluated. A prevalence of 0.33% (2/600) and 33.33% (1/3) properties were found for positive animals. Each assessed property had a questionnaire to analyze the epidemiological data management and relevant aspects for the disease occurrence. To confirm the positive tuberculin test results, PCR was used to detect and identify the pathogenic mycobacteria involved in the infection. It is concluded that most of the properties performing goat breeding in the region show low technification levels and promote farming between different species. Low prevalence of the disease alerts preventive measures to avoid major proportion situations that could influence the goat breeding in the state.

Spatial and Temporal Distribution of Mycobacterium tuberculosis Complex Infection in Eurasian Badger (Meles meles) and Cattle in Asturias, Spain.

Simple SummaryThe aim of the present work was to investigate the prevalence, spatial distribution, and temporal distribution of tuberculosis in 673 free-ranging Eurasian badgers (Meles meles) and cattle from Asturias (Atlantic Spain) during a 13-year follow-up. The study objective was to assess the role of badgers as a reservoir of tuberculosis for cattle and other sympatric wild species in the region. During the follow-up, 27/639 badgers (4.23%) were positive for the Mycobacterium tuberculosis complex based on bacterial isolation, while 160/673 (23.77%) were positive based on P22 ELISA. Badger infection was spatially and temporally associated with cattle herd infection.The present work investigated the prevalence, spatial distribution, and temporal distribution of tuberculosis (TB) in free-ranging Eurasian badgers (Meles meles) and cattle in Asturias (Atlantic Spain) during a 13-year follow-up. The study objective was to assess the role of badgers as a TB reservoir for cattle and other sympatric wild species in the region. Between 2008 and 2020, 673 badgers (98 trapped and 575 killed in road traffic accidents) in Asturias were necropsied, and their tissue samples were cultured for the Mycobacterium tuberculosis complex (MTC) isolation. Serum samples were tested in an in-house indirect P22 ELISA to detect antibodies against the MTC. In parallel, data on MTC isolation and single intradermal tuberculin test results were extracted for cattle that were tested and culled as part of the Spanish National Program for the Eradication of Bovine TB. A total of 27/639 badgers (4.23%) were positive for MTC based on bacterial isolation, while 160/673 badgers (23.77%) were found to be positive with the P22 ELISA. The rate of seropositivity was higher among adult badgers than subadults. Badger TB status was spatially and temporally associated with cattle TB status. Our results cannot determine the direction of possible interspecies transmission, but they are consistent with the idea that the two hosts may exert infection pressure on each other. This study highlights the importance of the wildlife monitoring of infection and disease during epidemiological interventions in order to optimize outcomes.

Latent tuberculosis screening before kidney transplantation in the South of Brazil.

Background:Tuberculosis (TB) is a prevalent infection after kidney transplantation (KT) in high-burden countries. Latent tuberculosis infection (LTBI) screening includes previous TB history, chest radiograph findings, and tuberculin test (TST) and/or interferon-gamma release assays (IGRAs) results. We aimed to compare our routine LTBI screening of KT candidates and living donors (LD) with their IGRA results, and evaluate if this would improve isoniazid (INH) treatment referral.Methods:We evaluated adult KT candidates and LD with complete routine LTBI screening and QuantiFERON-TB® Gold In-Tube (QFT) testing. Blood samples were collected from April 4th, 2014 to October 31st, 2018, with follow-up until October 31st, 2019.Results:There were 116 KT recipients, with 30% QFT-positive results. Positive QFT was associated with past TB history (p=0.007), positive TST (p<0.0001), residual radiographic lesions (p=0.003), and diabetes (p=0.035). There were 25 LD, 40% had positive QFT. Positive QFT was associated with a positive TST (p=0.002). Positive QFT results increased INH referral in 80%. Post-transplant TB incidence was 2.6% in a median follow-up of 2 (1-33) months. No variables were associated with post-transplant TB. TB patients had inferior, although non-significant, 5-year graft survival (66.7% vs. 76.5%) (p = 0.402).Conclusion:In the present study, the association of QFT to our routine LTBI screening incremented INH treatment referral, but there was still a high incidence of post-transplant TB, possibly related to other forms of infection, such as new exposure and donor transmission.

Tuberculosis caused by Mycobacterium caprae in a camel (Camelus dromedarius)

BackgroundAnimal tuberculosis (TB) is distributed worldwide and has a wide range of wild and domestic reservoirs. Few studies concerning TB in camelids have been published in the last decade, particularly as regards Old World Camelids (OWC), but the increase in reports of TB outbreaks in these species in recent years suggests a high susceptibility to the infection.Case presentationWe studied a dromedary camel (Camelus dromedarius) herd (n = 24) in which a Mycobacterium caprae infection was detected. The TB infection was confirmed in one animal at necropsy through the detection of TB lesions, mainly in the abdominal organs, and the subsequent isolation of M. caprae (SB0157 spoligotype). The whole herd was additionally tested using cellular and humoral based diagnostic techniques. The intradermal tuberculin test results were compared with those obtained using P22 ELISA for the detection of specific antibodies against the M. tuberculosis complex. The TB infected animal was a positive reactor to both the intradermal tuberculin tests and P22 ELISA, while the others were negative to all the diagnostic tests.ConclusionThe present study found M. caprae infection in OWC. This is the first report of M. caprae infection in an OWC not living in a zoo. Since the animal was born in the herd and fed with goat’s milk, this practice was suspected to be the potential source of TB infection, which was not confirmed in the other animals present in the herd. Moreover, our results highlight that the intradermal tuberculin test and the P22 ELISA could be valuable tools for the diagnosis of TB in OWC.

Influence of vaccination against paratuberculosis on the diagnosis of caprine tuberculosis during official eradication programmes in Castilla y León (Spain)

The information generated from the official eradication programmes of caprine tuberculosis (TB) in Castilla y León, Spain, during 2018, has been used to assess the effect of vaccination against paratuberculosis (PTB) and the presence of this infection, on the single intradermal tuberculin (SIT) test results. Data from 121,665 goats belonging to 1936 different herds were analysed using generalized linear models. An epidemiological survey was conducted to know the herd immunization status against PTB and the date of last vaccination. All SIT test-positive animals were further investigated in order to confirm the diagnosis of TB, through bacterial culture, and PTB, by histopathological and qPCR analyses. SIT positivity was found in 39 (2.01%) herds and 507 (0.41%) goats. TB was confirmed by M.caprae or M.bovis isolation in 10 (0.51%) herds and 46 (0.038%) goats. PTB was diagnosed in 13 (33.33%) and 55 (10.84%) of the SIT test-positive herds and goats, respectively. Vaccination against PTB showed a significant influence on the results of the SIT test at herd level, with higher positivity detected among those herds vaccinated. However, this effect was not observed when the total number of animals was considered, where the highest positivity was found in unvaccinated goats. The time elapsed between vaccination and SIT test performance also influenced the results. The strongest effect was found when less than eight months elapsed between performing both activities, and to a lesser extent between 8 and 12months. Conversely, no positive herds or animals were found when the time elapsed was higher than one year. No significant effect of the presence of PTB was observed. These findings demonstrate that the use of PTB vaccine does not result in false positives to a SIT test at individual level, provided that the time elapsed between the performance of both practices is higher than 12months.

Performance of immunohistochemistry versus real-time PCR method for detecting mycobacterial infections of cattle ‎ screened by comparative tuberculin test.

In addition to the fifty years since the test-and-slaughter program began in Iran and despite a significant reduction in the disease prevalence, positive tuberculosis cases are still being isolated from livestock farms across the country. Tests with 100% sensitivity and specificity are essential features for bovine tuberculosis diagnosis. The relationship between real-time PCR and immunohistochemistry (IHC) as two essential laboratory methods in the diagnosis of bacterial infections were aimed to evaluate single intradermal comparative tuberculin test (SICTT) results. One hundred thirty-eight cows in two groups were examined: Reactors (108 cows) and clean (as a control group; 30 cows). In the reactor group, 58(54.00%) cows were Mycobacterium bovis positive, 46(43.00%) were Mycobacterium avium subsp. paratuberculosis (MAP) positive, and 11(10.00%) were Mycobacterium tuberculosis positive. 32(55.00%) cows were co-infected with M. bovis and MAP and 5(4.55%) cows were co-infected with Mycobacterium tuberculosis and MAP in this group. Of 50 M. bovis negative cows of reactor group were 14(28.00%) MAP positive and 36(72.00%) negative, as well. Concurrent infection with all was observed in one reactor case. Comparing IHC and real-time PCR for the detection of bovine tuberculosis and Johne’s disease showed very good agreement (Kappa values 0.81 - 1.00). The results also provided further confirmation on IHC and real-time PCR as a sensitive and reliable diagnostic screening approach for detection of bovine tuberculosis. The use of one laboratory method to detect bovine tuberculosis is not sufficient alone.

History Of Tuberculosis Contact And Tuberculin Test Result

Introduction: Tuberculosis (TB) is a chronic disease caused by Mycobacterium tuberculosis. History of tuberculosis contact has consequences for TB infection. Density of occupancy may also accelerate TB transmission. Tuberculin test is a screening method that can detect TB infection. However, BCG immunization can reduce the specificity of tuberculin test results because it causes false positive results. Aim: The aim of this study is to see the relationship between history of TB contact and tuberculin test results. Other variables related to tuberculin test results were also examined i.e. occupancy density and incidence of BCG immunization. Methods: This research was conducted with cross-sectional analytic design using contingency coefficient test with a value of ɑ = 0.1. TB contacts subjects were taken from Surabaya Pulmonary Hospital and non-TB contacts subjects were volunteers from Medical Faculty of Widya Mandala Catholic University volunteers and Medical Faculty of Wijaya Kusuma. Each group consisted of 25 people taken using consecutive sampling technique. There is a significant correlation between history of tuberculosis contact and tuberculin test (p = 0,000); There is no significant correlation between BCG immunization history and tuberculin test results (p = 0.221) Result: There is a significant correlation between occupancy density and tuberculin test results (p = 0.066). Conclusion: It can be concluded that history of tuberculosis contact and occupancy density are associated with positive tuberculin test results.

The Case for Retiring the Tuberculin Skin Test.

* Abbreviations: BCG — : Bacillus Calmette-Guerin CDC — : Centers for Disease Control and Prevention IGRA — : interferon γ release assay LTBI — : latent tuberculosis infection TST — : tuberculin skin test The Mantoux tuberculin test (TST) is likely the oldest widely used test in contemporary diagnostics. In the past, when its obvious weaknesses were considered, it always “received a pass” because of the lack of an alternative test. However, with the advent and improvement of interferon γ release assays (IGRAs), we feel it is past time to reconsider the widespread use of TSTs. An adolescent with inflammatory bowel disease refractory to steroids was tested for latent tuberculosis infection (LTBI). The TST result was read as positive by a nurse and negative by a physician who had never seen a positive TST result. The patient was not treated for LTBI, received infliximab, and 2 months later developed cavitary pulmonary tuberculosis. Contact tracing identified 2 relatives and several classmates with LTBI and a younger sibling with intrathoracic tuberculosis. How can we do better? IGRAs, or blood tests for the diagnosis of tuberculosis infection in place of TSTs, have been licensed in the United States since 2001. IGRAs are now recommended for use for children as young as 2 years of age1 and are recommended by the Centers for Disease Control and Prevention (CDC) for adults in all situations in which a TST has … Address correspondence to Andrea T. Cruz, MD, MPH, Department of Pediatrics, Baylor College of Medicine, 6621 Fannin St, Suite A2210, Houston, TX 77030. E-mail: acruz{at}bcm.edu

Comparison of GeneXpert MTB to Mycobacterium tuberculosis culture in children with tuberculosis

Background Diagnosing tuberculosis (TB) in children is difficult. Typical methods take a long time to achieve results, or have a low sensitivity. GeneXpert is a nucleic acid amplification test used to identify Mycobacterium tuberculosis bacteria (MTB) in only 2 hours.&#x0D; Objective To compare the sensitivity and specificity of GeneXpert MTB to MTB culture in children with TB, and to assess factors associated with GeneXpert MTB test in predicting which children were likely to have positive results.&#x0D; Methods This descriptive, analytical study was done in children with suspected TB, aged 1 month to 18 years in Hasan Sadikin Hospital, Bandung, West Java, from January 2016 to December 2017. The data were taken from the medical records and included age, gender, nutritional status, symptoms of TB, chest x-ray, and tuberculin test results. The GeneXpert MTB test was compared to cultures from the same patient, with regards to sensitivity, specificity, and agreement using Kappa index. We analyzed factors associated to GeneXpert MTB test using logistic regression analysis.&#x0D; Results From 454 inpatients and 1,750 outpatients with suspected TB, there were 251 children who were tested by MTB culture and 722 children tested by GeneXpert MTB. Of the 70 cases who met the inclusion criteria and underwent both tests, factors associated with positive GeneXpert MTB results were age 10 to 18 years, female gender, and positive tuberculin skin test (TST). The GeneXpert MTB test showed sensitivity 78.9% (95%CI 56.7 to 91.5) and specificity 86.3% (95%CI 74.3 to 93.2), with accuracy of 84.3% (95%CI 74 to 91), and agreement value of ƙ=0.62 (95%CI 41.6 to 82.7).&#x0D; Conclusion Specificity of GeneXpert MTB is higher than its sensitivity compared to TB cultures in children. The tests were in good agreement. Age 10 to 18 years had the strongest association with positive GeneXpert MTB results.

The role of genexpert in diagnosis of sputum-negative pulmonary tuberculosis

Background The GeneXpert MTB/RIF assay is a new diagnostic test that depends on a real-time PCR analysis of the sample for diagnosis of tuberculosis (TB) and detection of rifampicin resistance. Aim The aim was to evaluate the role of role of GeneXpert in the diagnosis of sputum-negative pulmonary TB. Patients and methods This study included 30 patients suspected to have TB, with mean age being 45.5±17.7 years. All patients had clinical and radiological signs consistent with TB, positive tuberculin test results, and three negative Ziehl–Neelsen sputum smears. Patients having no or incomplete data were excluded from the study. Results This study included 30 patients suspected to be have TB, comprising 24 (80%) males and six (20%) females. Their age ranged from 18 to 70 years, with a mean age of 45.5±17.7 years. They were selected from the Chest Departments of Bab El-Sha’eria, Al-Hussein University, and El-Abbasia Chest Hospitals in the period from February 2017 to December 2017. All patients have clinical and radiological signs consistent with TB, positive tuberculin test results, and three negative Ziehl–Neelsen sputum smears. Our study showed that GeneXpert was positive in 11 (36.7%) patients and negative in 19 (63.3%) patients. Conclusion The GeneXpert assay can be used as a gold standard to diagnose TB. As it is sensitive and specific for diagnosing smear-negative pulmonary TB, the assay is faster than culture.

ANALYSIS OF TUBERCULIN SKIN TEST IN ADULT ASTHMATIC PATIENTS USING STEROIDS AS PART OF THEIR MANAGEMENT

BACKGROUND: Tuberculosis infection being one of the major risk factor for morbidity and mortality in developing countries according to WHO and CDC. The risk of developing TB increases significantly with the drop of immunity.Using steroid (prednisolone or its equivalent) at a dose of more than 15 mg/day more than 4 weeks is associated with significant drop in immunity, hence increasing the risks of being infected with TB to eight folds AIM OF THE STUDY: To assess the risk of developing TB infection in asthmatic patients that use steroid in their asthma treatment regime.MATERIALS &amp;amp; METHODS: A prospective study designed to include patients complaining from Asthma who have visited Baghdad teaching hospital in the period from (June 2016 to June 2017) that included in-patients and out-patients.A questionnaire prepared to document the related information of most concern to the researcher and for the sake of study. RESULTS: In this study, we managed to enroll 60 patients. Male to female ratio was 7:23. 80% of the study cohort lived in urban residence and 20 % in suburban neighborhood. 33.3% of the patients had diabetes as comorbidity. 21.7 % of the patients used inhaled steroid as a modality of management of asthma, while 45% used systemic steroids, and 33.3 % used combined modality. Of the study cohort, 18.3 % used steroid for no more than 4 weeks, and the rest used it for more than 4 weeks. Regarding tuberculin test results, 11.7 % test positive.A significant correlations were found between the tuberculin test and the increasing age of the patient p=0.01, and the duration of use of steroids p=0.001, also, between TST and previous history of TB p=0.04.CONCLUSION: There is no relationship between the type of steroid and the risk of getting TB infection.The risk of steroid on immune system and the raise of risk increase with increasing subject age. The extended period of exposure to steroid will definitely increase the risk of TB infection.

ANTIRETROVIRAL ROLE IN TUBERCULOSIS PREVENTION AMONG PEOPLE LIVING WITH HUMAN IMMUNODEFICIENCY VIRUS (RETROSPECTIVE COHORT CLINICAL STUDY)

Antiretroviral therapy is one of the most effective strategies for preventing tuberculosis among people living with HIV. It significantly reduces the risk of tuberculosis, regardless of immunosuppression level, results of tuberculin tests and prevalence of drug-resistant tuberculosis in the region. The results of the retrospective cohort study conducted at the Pskov Regional AIDS Center from 2007–2016 convincingly confirmed the importance of the ART in preventing the TB development in patients with HIV. Of the 814 subjects included in the study, 590 – received ART, 305 – did not receive it. In compared groups TB was more likely developed in patients without antiretroviral therapy, RR 0,37 (95% CI 0,20–0,49), they were more likely to die of tuberculosis, RR 0,20 (95% CI 0,065-0,4), and among them more likely occurred other opportunistic diseases, RR 0,53 (95% CI 0,35–0,75). Among those receiving ARVT, tuberculosis and other opportunistic diseases developed more often in individuals with CD4 350 cells/ml, there were no lethal outcomes of tuberculosis, RR 0.23 (95% CI 0.0-2.0).

НЕДОСТАТОЧНОСТЬ ИНДЕКСА ПИТАНИЯ КАК ОДИН ИЗ ПРЕДИКТОРОВ РАЗВИТИЯ ТУБЕРКУЛЁЗА В СТРАНЕ С ВЫСОКИМ БРЕМЕНЕМ ЗАБОЛЕВАНИЯ

Objective: The comparative study of nutrition index in healthy persons and TB patients, residents of different regions of Tajikistan and determination of the relationship between the degree of protein-energy insufficiency of the body and the transition of latent tuberculosis into an active form of the disease. Methods: Under surveillance were 390 healthy persons and 200 patients with active tuberculosis, residents of different regions of Tajikistan. Comparable groups by sex, age characteristics and geography of places of residence were quite representative. All observed healthy subjects were put a tuberculin sample intradermally with 2 TE of the drug "TUBERCULIN PPD" according to a standard procedure. The diagnosis of tuberculosis made based on clinical and radiological data, as well as the results of sputum microscopy and its study on the GeneXpertRIF apparatus. All observed persons (healthy and sick with tuberculosis) were subjected to biochemical blood tests and trophological status calculations using standard formulas. Results: A tuberculin sample showed that of the 390 observed persons, 260 (66.7%) had a negative response, while the remaining 130 (33.3%) had a different reaction to a different degree. The nutrition status only 17.7% of healthy individuals corresponded to the graduation of light undernourishment whereas among sick patients with tuberculosis the insufficiency of food revealed 77.0% of cases, including 43.5% – light, 27.0% – medium and in 6.5% – a serious degree. Examining of the presence of infection with MTB and malnutrition status among the survey revealed that of 69 people with mild malnutrition in 41 (10.5%), the results of the tuberculin sample were positive. Conclusion: Infection of MTB according to the tuberculin sample is detected in one third of adults used by the studied persons. Individuals with a combination of malnutrition and positive tuberculin test results are at risk for developing tuberculosis, and they should conduct a course of chemoprophylaxis and improve the quality of nutrition. The majority of tuberculosis patients showed malnutrition, which testifies the importance of this starting mechanism of transition from a latent to an active form of the disease. Keywords: Nutrition index, tuberculosis, predictors, biochemical blood test, tuberculin sample.

Prevalence and Factors Associated with Tuberculosis Treatment Success among TB/HIV Co-Infection in North-East Malaysia.

One of the six strategies developed by WHO, in order to stop Tuberculosis (TB) is addressing TB/HIV high-risk groups. This study aimed to determine the prevalence of successful TB treatment and factors associated with TB treatment success among TB/HIV co-infection patients in North-East Malaysia. A cross-sectional study was carried out in the a-year period from 2003 to 2012 by reviewing TB/HIV records in all hospitals and health clinics. The outcome of interest was treatment success as defined by Ministry of Health (MOH) when the patients was cured or completed TB treatment. Out of 1510 total TB/HIV co-infection cases, 27.9% (95% CI: 25.2, 30.6) of the patients were having treatment success. A majority of TB/HIV co-infection cases were male (91.1%). Fifty-eight percent the patients were drug addicts and 6% were having positive tuberculin tests. The multiple logistic regression revealed that male (OR: 0.39, 95% CI: 0.22, 0.71) and positive tuberculin test result (OR: 2.61, 95% CI: 1.63, 4.19) were significantly associated with the treatment success of TB/HIV co-infection patients. Other factors such as age, comorbid, sputum smear and x-ray findings were not significantly factors in this study. Female patients and those with negative tuberculin test should be emphasised for successful tuberculosis treatment.