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Reactividad de la Tuberculina en escolares de primer año en Madagascar
Author(s) -
Raharimanga Vaomalala,
Ratovoson Rila,
Ratsitorahina Maherisoa,
Ramarokoto Herimanana,
Rasolofo Voahangy,
Talarmin Antoine,
Richard Vincent
Publication year - 2012
Publication title -
tropical medicine and international health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.056
H-Index - 114
eISSN - 1365-3156
pISSN - 1360-2276
DOI - 10.1111/j.1365-3156.2012.03013.x
Subject(s) - tuberculin , vaccination , medicine , tuberculosis , odds ratio , bcg vaccine , confidence interval , epidemiology , skin test , immunology , pediatrics , pathology
Objective The tuberculin skin test (TST) is an important tool in the diagnosis of tuberculosis infection in children. However, the interpretation of TST may be complicated by prior Bacillus Calmette‐Guerin (BCG) vaccination. We evaluated the effect of vaccination with BCG on TST reactivity in first‐year pupils attending state schools in Antananarivo. Methods STs were performed on 376 first‐year schoolchildren, aged 6 and 7, attending two state primary schools. The relationships between epidemiological information, BCG status (vaccination, BCG scars) and TST reactivity were assessed to compare TST sensitivity between children with and without BCG vaccination and between those with and without a BCG scar. Result The prevalence of positive TST results of ≥5, ≥10 and ≥ 15 mm was 20.2% (76/376), 18.3% (69/376) and 11.4% (43/376), respectively. BCG vaccination was not associated with TST reactivity, whatever the threshold used: ≥5 mm (odds ratio (OR, 1.2; 95% confidence interval (CI), 0.7–2.0); ≥10 mm (OR, 0.9; 95% CI, 0.6–1.7); ≥15 mm (OR, 0.6; 95% CI, 0.3–1.2). Conclusion These results suggest that in Madagascar, a positive TST result indicates TB infection (active or latent) rather than past BCG vaccination. Therefore, high BCG vaccination coverage does not appear to impair the usefulness of the TST as a tool for diagnosing tuberculosis.