Background: Diabetes mellitus (DM) patients with latent tuberculosis infection (LTBI) have an increased risk of developing active tuberculosis (TB) due to impaired immunity. The performance of currently available immune response-based assays for identification of TB infection had been rarely evaluated in patients with type 2 DM (T2DM) in China.
Methods: A prospective study was conducted to investigate the status of LTBI in patients with confirmed T2DM. At the baseline survey, the prevalence of LTBI was tested using interferon-gamma release assay (IGRA), tuberculin skin test (TST) and creation tuberculin skin test (C-TST) in parallel. After a 3-month interval, the participants were retested by the three assays to estimate their performance in the serial testing.
Results: A total of 404 participants with T2DM were included in the study. At baseline, after excluding active TB, the prevalence of LTBI identified by TST (≥ 10 mm), C-TST (≥ 5 mm) and IGRA (≥ 0.35 IU/ml) were 9.65% (39/404), 10.40% (42/404) and 14.85% (60/404), respectively. The concordance of TST and C-TST results with IGRA results was 86.39% (349/404) and 92.08% (372/404) with a Kappa coefficient of 0.37 [95% confidence interval (CI): 0.24- 0.50] and 0.64 (95% CI: 0.53- 0.76), respectively. After a 3-month interval, the continuous results of TST, C-TST and IGRA were observed to be increased with testing conversion for 50, 26 and 27 patients, respectively. For TST and C-TST conversions, the distribution of their quantitative results in serial tests varied significantly when further classified by baseline IGRA dichotomous results.
Conclusion: In studied patients with T2DM, C-TST showed higher consistency with IGRA as compared to TST. The present of conversion observed in serial testing suggested that boosting effect of skin testing should be considered for identify of LTBI in patients with T2DM.
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http://dx.doi.org/10.3389/fpubh.2022.1025550 | DOI Listing |
BMC Infect Dis
December 2024
Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, Jiangsu Province, PR China.
Background: This study aimed to evaluate the diagnostic performance of ESAT6-CFP10 (EC) skin test in healthy population and determine the factors influencing the booster effect.
Methods: We conducted a randomized, double-blind, parallel controlled trial in healthy population. The experiment was divided into two stages.
Lancet Microbe
December 2024
Amsterdam University Medical Centres, Amsterdam, Netherlands; Department of Global Health and Amsterdam Institute for Global Health and Development, Amsterdam, Netherlands.
Background: Tuberculosis vaccine trials using disease as the primary endpoint are large, time consuming, and expensive. An earlier immunological measure of the protection against disease would accelerate tuberculosis vaccine development. We aimed to assess whether the effectiveness of the Bacillus Calmette-Guérin (BCG) vaccine for prevention of Mycobacterium tuberculosis infection was consistent with that for prevention of tuberculosis disease.
View Article and Find Full Text PDFBMC Infect Dis
December 2024
Department of Internal Medicine, Asokoro District Hospital, Abuja, Nigeria.
Background: Tuberculosis (TB), caused by Mycobacterium tuberculosis, is a leading cause of infection-related deaths worldwide. Children with underdeveloped immune systems are particularly vulnerable, experiencing symptoms akin to common childhood illnesses. Early diagnosis and treatment typically yield positive outcomes.
View Article and Find Full Text PDFOncol Rev
December 2024
Faculty of Medicine, Tehran University of Medical Sciences (TUMS), Tehran, Iran.
Background: Latent tuberculosis (TB) can reactivate in immunocompromised individuals, such as cancer patients undergoing chemotherapy, leading to severe complications. Understanding the prevalence of latent TB in this high-risk group is crucial, especially in regions with moderate to high TB burdens.
Aim: This study aims to determine the prevalence of latent tuberculosis in cancer patients before chemotherapy and immunotherapy to guide preventive interventions and reduce the risk of TB reactivation.
N Engl J Med
December 2024
From the Faculty of Medicine and Health (G.J.F., P.N.Y., E.L.M., H.M.Y., E.G.-R., P.D.C., B.J.M., N.T.A.), the Sydney Infectious Diseases Institute (B.J.M.), and Sydney Medical School (H.M.Y.), University of Sydney, and Royal Prince Alfred Hospital, Sydney Local Health District (G.J.F.), Camperdown, NSW, the Woolcock Institute of Medical Research, Macquarie Park, NSW (G.J.F., N.C.B., P.N.Y., P.D.C., N.T.A., G.B.M.), the School of Clinical Medicine, University of New South Wales, Liverpool (F.L.G.), and the Department of Paediatrics, University of Melbourne (S.M.G.), and the Division of Global Health, Burnet Institute (G.B.M.), Melbourne, VIC - all in Australia; the University of Medicine and Pharmacy, Vietnam National University (N.V.N.), and the National Lung Hospital, Ba Dinh District (N.B.H., N.K.C.), Hanoi, and Pham Ngoc Thach Hospital, Ho Chi Minh City (N.H.L.) - all in Vietnam; the Departments of Medicine (A.B., O.S., M.A.B., D.M.), Epidemiology, Biostatistics, and Occupational Health (A.B., M.A.B., D.M.), and Microbiology and Immunology (O.S., M.A.B.), McGill University, Montreal; and Johns Hopkins University, Baltimore (D.W.D.).
Background: Prevention of drug-resistant tuberculosis is a global health priority. However, trials evaluating the effectiveness of treating infection among contacts of persons with drug-resistant tuberculosis are lacking.
Methods: We conducted a double-blind, randomized, controlled trial comparing 6 months of daily levofloxacin (weight-based doses) with placebo to treat infection.
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