Tuberculin skin test result and risk of death among persons with active TB.
BACKGROUND: Although the tuberculin skin test (TST) is frequently used to aid in the diagnosis of tuberculosis (TB) disease and to identify persons with latent TB infection, it is an imperfect test and approximately 10-25% of persons with microbiologically confirmed TB disease have a negative TST. P...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Public Library of Science (PLoS)
2013-01-01
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| Series: | PLoS ONE |
| Online Access: | http://europepmc.org/articles/PMC3823982?pdf=render |
| _version_ | 1818457311302123520 |
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| author | Sara C Auld Eleanor S Click Charles M Heilig Roque Miramontes Kevin P Cain Gregory P Bisson William R Mac Kenzie |
| author_facet | Sara C Auld Eleanor S Click Charles M Heilig Roque Miramontes Kevin P Cain Gregory P Bisson William R Mac Kenzie |
| author_sort | Sara C Auld |
| collection | DOAJ |
| description | BACKGROUND: Although the tuberculin skin test (TST) is frequently used to aid in the diagnosis of tuberculosis (TB) disease and to identify persons with latent TB infection, it is an imperfect test and approximately 10-25% of persons with microbiologically confirmed TB disease have a negative TST. Previous studies have suggested that persons with a negative TST are more likely to present with severe TB disease and have an increased rate of TB-related death. METHODS: We analyzed culture-confirmed TB cases captured in US TB surveillance data from 1993 to 2008 and performed multivariate logistic regression analysis to determine the association between TST result and death. RESULTS: Of 284,866 cases of TB reported in the US, 58,180 persons were eligible for inclusion in the analysis and 3,270 of those persons died after initiating TB treatment. Persons with a negative TST accounted for only 14% of the eligible cases but accounted for 42% of the deaths. Persons with a TST≥15 mm had 67% lower odds of death than persons with a negative TST (adjusted odds ratio 0.33, 95% confidence interval 0.30-0.36). CONCLUSIONS: A negative TST is associated with an increased risk of death among persons with culture-confirmed TB disease, even after adjustment for HIV status, site of TB disease, sputum smear AFB status, drug susceptibility, age, sex, and origin of birth. In addition to indicating risk of developing disease, the TST may also be a marker for increased risk of death. |
| first_indexed | 2024-12-14T22:40:33Z |
| format | Article |
| id | doaj.art-2e6a05e7794347ce998646175b9c58ce |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-12-14T22:40:33Z |
| publishDate | 2013-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-2e6a05e7794347ce998646175b9c58ce2022-12-21T22:44:59ZengPublic Library of Science (PLoS)PLoS ONE1932-62032013-01-01811e7877910.1371/journal.pone.0078779Tuberculin skin test result and risk of death among persons with active TB.Sara C AuldEleanor S ClickCharles M HeiligRoque MiramontesKevin P CainGregory P BissonWilliam R Mac KenzieBACKGROUND: Although the tuberculin skin test (TST) is frequently used to aid in the diagnosis of tuberculosis (TB) disease and to identify persons with latent TB infection, it is an imperfect test and approximately 10-25% of persons with microbiologically confirmed TB disease have a negative TST. Previous studies have suggested that persons with a negative TST are more likely to present with severe TB disease and have an increased rate of TB-related death. METHODS: We analyzed culture-confirmed TB cases captured in US TB surveillance data from 1993 to 2008 and performed multivariate logistic regression analysis to determine the association between TST result and death. RESULTS: Of 284,866 cases of TB reported in the US, 58,180 persons were eligible for inclusion in the analysis and 3,270 of those persons died after initiating TB treatment. Persons with a negative TST accounted for only 14% of the eligible cases but accounted for 42% of the deaths. Persons with a TST≥15 mm had 67% lower odds of death than persons with a negative TST (adjusted odds ratio 0.33, 95% confidence interval 0.30-0.36). CONCLUSIONS: A negative TST is associated with an increased risk of death among persons with culture-confirmed TB disease, even after adjustment for HIV status, site of TB disease, sputum smear AFB status, drug susceptibility, age, sex, and origin of birth. In addition to indicating risk of developing disease, the TST may also be a marker for increased risk of death.http://europepmc.org/articles/PMC3823982?pdf=render |
| spellingShingle | Sara C Auld Eleanor S Click Charles M Heilig Roque Miramontes Kevin P Cain Gregory P Bisson William R Mac Kenzie Tuberculin skin test result and risk of death among persons with active TB. PLoS ONE |
| title | Tuberculin skin test result and risk of death among persons with active TB. |
| title_full | Tuberculin skin test result and risk of death among persons with active TB. |
| title_fullStr | Tuberculin skin test result and risk of death among persons with active TB. |
| title_full_unstemmed | Tuberculin skin test result and risk of death among persons with active TB. |
| title_short | Tuberculin skin test result and risk of death among persons with active TB. |
| title_sort | tuberculin skin test result and risk of death among persons with active tb |
| url | http://europepmc.org/articles/PMC3823982?pdf=render |
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