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The Prevalence Rate of Tuberculin Skin Test Positive by Contacts Group to Predict the Development of Active Tuberculosis After School Outbreaks

Authors
Kim, Hee JinChun, Byung ChulKwon, Amy M.Lee, Gyeong-HoRyu, SungweonOh, Soo YeonLee, Jin BeomYoo, Se HwaKim, Eui SookKim, Je HyeongShin, CholLee, Seung Heon
Issue Date
10월-2015
Publisher
TAEHAN KYORHAEK HYOPHOE-KOREAN ACAD TUBERCULOSIS & RESPIRATORY DISEASES
Keywords
Adolescent; Disease Outbreaks; Tuberculin Test; Latent Tuberculosis; Tuberculosis
Citation
TUBERCULOSIS AND RESPIRATORY DISEASES, v.78, no.4, pp.349 - 355
Indexed
SCOPUS
KCI
Journal Title
TUBERCULOSIS AND RESPIRATORY DISEASES
Volume
78
Number
4
Start Page
349
End Page
355
URI
https://scholar.korea.ac.kr/handle/2021.sw.korea/92354
DOI
10.4046/trd.2015.78.4.349
ISSN
1738-3536
Abstract
Background: The tuberculin skin test (TST) is the standard tool to diagnose latent tuberculosis infection (LTBI) in mass screening. The aim of this study is to find an optimal cut-off point of the TST+ rate within tuberculosis (TB) contacts to predict the active TB development among adolescents in school TB outbreaks. Methods: The Korean National Health Insurance Review and Assessment database was used to identify active TB development in relation to the initial TST (cut-off, 10 mm). The 7,475 contacts in 89 schools were divided into two groups: Incident TB group (43 schools) and no incident TB group (46 schools). LTBI treatment was initiated in 607 of the 1,761 TST+ contacts. The association with active TB progression was examined at different cut-off points of the TST+ rate. Results: The mean duration of follow-up was 3.9 +/- 0.9 years. Thirty-three contacts developed active TB during the 4,504 person-years among the TST+ contacts without LTBI treatment (n=1,154). The average TST+ rate for the incident TB group (n=43) and no incident TB group (n=46) were 31.0% and 15.5%, respectively. The TST+ rate per group was related with TB progression (odds ratio [OR], 1.025; 95% confidence interval [CI], 1.001-1.050; p=0.037). Based on the TST+ rate per group, active TB was best predicted at TST+ >= 16% ( OR, 3.11; 95% CI, 1.29-7.51; area under curve, 0.64). Conclusion: Sixteen percent of the TST+ rate per group within the same grade students can be suggested as an optimal cut-off to predict active TB development in middle and high schools TB outbreaks.
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