Özkan KARAMAN, Özden ANAL, Nevin UZUNER, Arzu HOCAOĞLU BABAYİĞİT, Duygu ERGE ÖLMEZ, Balahan MAKAY

Characteristics of children with positive tuberculin skin test

Bu çalışmanın amacı; pozitif tüberkülin cilt testi ile latent tüberküloz tanısı konulan çocuk hastalar için potansiyel risk faktörlerini değerlendirmektir. Latent tüberküloz tanısı ile izlenmekte olan çocuk hastalar retrospektif olarak çalışmaya dahil edildi. Hastaların atopi öyküsü, geçirilmiş solunum yolu infeksiyonları, tüberküloz ve atopi açısından aile öyküsü, BCG aşı sayısı, fizik muayene bulguları ve laboratuvar sonuçlarını içeren demografik özellikleri hastaların dosyalarından kaydedildi. Tüberkülin cilt testi pozitifliği saptanan 81 (51 erkek, 30 kız) çocuk bu çalışma kapsamında değerlendirildi. Hastaların ortalama yaşları 8.00 ± 4.00 idi. Sadece 13 (%16) çocuğun aktif tüberkülozlu birey ile temas öyküsü mevcuttu. Hastaların yaşları, BCG aşı ve skar sayısının tüberkülin cilt testi reaksiyon büyüklüğünü istatistiksel olarak önemli oranda etkilemekte olduğu gösterildi. Tüberkülin cilt testi reaksiyon büyüklüğü, son doz BCG aşısından sonra geçen süre, ailede aktif tüberküloz ve tüberkülin cilt testi pozitif birey varlığı, sigara maruziyeti, ailenin birey sayısı ve allerjik solunum yolu hastalığı varlığı ile etkilenmediği tespit edildi. Hastanın yaşı, BCG aşı ve skar sayısının çocukluk çağında tüberkülin cilt testi sonuçlarını önemli ölçüde etkilediği gösterildi. Bu durum, latent tüberküloz tanısı koymada ve profilaktik tedavi başlanması kararında güçlüklere neden olabilir. Bu çalışmanın sonuçları, latent tüberküloz tanısı koymak için daha yüksek maliyetli ve sofistike laboratuvar gerektiren yeni geliştirilmiş, daha doğru ve güvenilir sonuçlar veren in vitro testlerin kullanılabileceğini düşündürmektedir.

Tüberkülin cilt testi pozitif saptanan çocukların özellikleri

The aim of the study was to define the characteristics of children with latent tuberculosis diagnosed with positive tuberculin skin test (TST) and evaluate potential risk factors in children with positive TST. Children followed with the diagnosis of latent tuberculosis infection were included in the study retrospectively. Demographic characteristics of patients including history of atopy, respiratory infections, family history of tuberculosis and atopy, number of BCG vaccinations, findings of physical examination and laboratory data were extracted from patient’s file. Eighty-one children (51 male, 30 female) who had positive TST were retrospectively evaluated in the study. Mean age of the patients was 8.00 ± 4.00 years. Only 13 (16%) of the children had contact with a case who had active tuberculosis. It was shown that the age of the patients, number of BCG scars and BCG vaccination significantly affected TST reaction size. TST size was not affected with time passed after last dose of BCG vaccination, family history of tuberculosis, presence of TST positive case in the family, exposure to cigarette smoke, number of household family members and presence of respiratory allergic disease. The patient’s age, numbers of BCG vaccination and BCG scars significantly affect TST results in childhood. This may cause difficulty in diagnosing latent tuberculosis infection and in decision of initiating prophylactic treatment. The results of this study may show that recently developed, more accurate and convenient in vitro tests that they have higher costs and require sophisticated laboratory, can be used to diagnose latent tuberculosis.

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