The prevalence of tuberculin skin test positivity and the effect of BCG vaccinations on tuberculin induration size in the eastern Mediterranean region of Turkey

To evaluate the prevalence of tuberculin skin test (TST) positivity in Kahramanmaraş and interpret the size of purified protein derivative (PPD) induration with respect to the number of Bacillus Calmette-Guerin (BCG) scars and other factors. Materials and methods: A total of 2979 school children between the ages of 7 and 17 years were evaluated. On the basis of socioeconomic levels, 11 schools were selected and categorized into 3 subgroups: schools in the suburbs of the city (Group 1), schools in the city center (Group 2), and private schools (Group 3). Children were injected with 5 TU/0.1 mL of PPD and the sizes of induration were measured after 72 h. The number of BCG scars and the sizes of induration were recorded for each pupil. Results: The TST was positive in 6.3% of the nonvaccinated students and in 7.5% of the vaccinated students (P > 0.05). The number of BCG vaccination scars was 0 in 174 children (5.8%), 1 in 1232 children (41.4%), 2 in 1516 children (50.9%), 3 in 54 children (1.8%), and 4 in 3 children (0.1%). The mean diameter of the size of the PPD induration for 0, 1, 2, 3, and 4 BCG vaccinations was 2.50 ± 4.05 mm, 5.60 ± 5.11 mm, 8.49 ± 5.09 mm, 8.46 ± 4.38 mm, and 7.66 ± 6.80 mm, respectively. The size of the induration was greatest in students vaccinated twice (P < 0.05). The TST positivity rate was highest in children 11-13 years of age (P < 0.05). Conclusion: The BCG vaccination rate was higher in Kahramanmaraş, whereas the TST positivity rate was lower. The factors that affected the size of the PPD induration were the number of vaccination scars and the age of the subject.

The prevalence of tuberculin skin test positivity and the effect of BCG vaccinations on tuberculin induration size in the eastern Mediterranean region of Turkey

To evaluate the prevalence of tuberculin skin test (TST) positivity in Kahramanmaraş and interpret the size of purified protein derivative (PPD) induration with respect to the number of Bacillus Calmette-Guerin (BCG) scars and other factors. Materials and methods: A total of 2979 school children between the ages of 7 and 17 years were evaluated. On the basis of socioeconomic levels, 11 schools were selected and categorized into 3 subgroups: schools in the suburbs of the city (Group 1), schools in the city center (Group 2), and private schools (Group 3). Children were injected with 5 TU/0.1 mL of PPD and the sizes of induration were measured after 72 h. The number of BCG scars and the sizes of induration were recorded for each pupil. Results: The TST was positive in 6.3% of the nonvaccinated students and in 7.5% of the vaccinated students (P > 0.05). The number of BCG vaccination scars was 0 in 174 children (5.8%), 1 in 1232 children (41.4%), 2 in 1516 children (50.9%), 3 in 54 children (1.8%), and 4 in 3 children (0.1%). The mean diameter of the size of the PPD induration for 0, 1, 2, 3, and 4 BCG vaccinations was 2.50 ± 4.05 mm, 5.60 ± 5.11 mm, 8.49 ± 5.09 mm, 8.46 ± 4.38 mm, and 7.66 ± 6.80 mm, respectively. The size of the induration was greatest in students vaccinated twice (P < 0.05). The TST positivity rate was highest in children 11-13 years of age (P < 0.05). Conclusion: The BCG vaccination rate was higher in Kahramanmaraş, whereas the TST positivity rate was lower. The factors that affected the size of the PPD induration were the number of vaccination scars and the age of the subject.

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  • Starke JR. Tuberculosis. In: Jenson HB, Baltimore RS, editors. Pediatric infectious diseases. 2nd edition, Philadelphia: WB Saunders; 2002. p.396-419.
  • Trunz BB, Fine P, Dye C. Eff ect of BCG vaccination on childhood tuberculous meningitis and miliary tuberculosis worldwide: a meta-analysis and assessment of cost-eff ectiveness. Lancet 2000; 367: 1173-80.
  • Arpaz S, Keskin S, Kıter G, Sezgin N, Uçan ES. Retrospective evaluation of pediatric tuberculosis patients. Toraks 2001; 2: 27-33.
  • Batra V, Ang JY. Tuberculosis: Follow-up. Updated 30 October 2008. followup. Accessed on 12 June 2009.
  • Colditz GA, Brewer TF, Berkey CS, Wilson ME, Burdick E, Fineberg HV et al. Effi cacy of BCG vaccine in the prevention of tuberculosis – meta-analysis of the published literature. JAMA 1994; 271: 698-702.
  • Soysal A, Bakır M. Diagnosis in tuberculous infections tuberculin skin test. J Pediatr Inf 2007; 1: 27-32.
  • American Th oracic Society. Treatment of tuberculosis and tuberculosis infection in adults and children. Am J Respir Crit Care Med 1994; 149: 1359-74.
  • Koçoğlu F. Tüberküloz vakalarının erken teşhisi. In: Kocabaş A, editor. Tüberküloz kliniği ve kontrolü. Adana; 1991. p.237- 41.
  • Özkara Ş, Aktaş Z, Özkan S, Ecevit H. Türkiye’de tüberkülozun kontrolü için başvuru kitabı. Ankara: T.C. Sağlık Bakanlığı Verem Savaşı Daire Başkanlığı; 2003.
  • Iseman MD. Tuberculosis guideline for clinicians (translated by Özkara Ş). Ankara: Nobel Tıp Kitabevi; 2002. p.97-125, 271- 322.
  • Pamukçu A, Baskın E, Büyükbeşe E, Gökalp AS. BCG evaluation with PPD reaction. XXI. Turkish Tuberculosis and Chest Diseases Congress, Congress Book; 1996. p.9-15.
  • Akkaya A, Kalan S, Ünlü M. Tuberculin skin test positivity in Isparta city and neighbourhood. SDÜ Tıp Fak Derg 1994; 1: 18-21.
  • Şakar A, Göktalay T, Dağyıldızı L, Yıldırım CA, Yorgancıoğlu A. Screening of tuberculosis in school children in Manisa city. Toraks 2002; 4: 38-42.
  • Kolsuz M, Kıyak O, Metintaş S, Metintaş M, Erginel S. Tuberculin skin test screening and microfi lm results of TST positive family members. Toraks 2002; 3: 296-302.
  • Özyardımcı N, Yüksel EG, Karadağ M, Uzaslan EK. Prevalence of tuberculosis infection in 6-12 age group children in Bursa c ity center and villages. Tüberk Toraks 1997; 45: 83-8.
  • Özkurt Ş, Fişekçi F, Türe M, Akdağ B. Results of tuberculin skin test between 1993 and 1995 in schools of Bursa city. Tüberk Toraks 2001; 49: 108-12.
  • Uzun K, Özbay B, Akman N, Ceylan E, Ağca F, Şenel M. Results of PPD test in Van city in 1997. Tüberk Toraks 2000; 48: 238-42.
  • Özdemir MN, Ekici MS, Metintaş M. Tuberculin skin test results in school children in Eskişehir and screening results of family members of children having induration above 20 mm. Solunum 1987; 12: 450-5.
  • Kurçer MA, Genç M, Eğri M, Pehlivan E. Response to PPD skin test in nursery children. Tüberk Toraks 2000; 48: 340-4.
  • Özlu T, Çan G, Torun P, Türker S, Demirbaş M, Telatar M. Tuberculin skin test screening in school children in Trabzon city. Tüberk Toraks 1997; 45: 89-93.
  • Uçan ES, Sevinç C, Abadoğlu Ö, Arpaz S, Ellidokuz H. Interpretation of tuberculin skin tests, country standards and new requirements. Toraks 2000; 1: 25-9.
  • Uzun K, Gençer M, Gülsün A, Ceylan E, Ağca F. PPD results of children immigrated to city center from rural areas in Van city. Solunum 2000; 2: 91-5.
  • Çakıcı N, Ülgey N, Yalçın YI. BCG scar control and results of tuberculin test of primary school children in Çanakkale. Klimik 2006; 19: 75-8.
  • Turkish Ministry of Health. www.saglik.gov.tr/gbpgenelge.pdf.
  • Ceylan E. Evaluation of new tuberculosis patients followed- up by Bingöl tuberculosis prevention and treatment center in 1999-2000. Akciğer Arşivi 2004; 1: 26-30.
  • Tanrıkulu Ç, Abakay A, Abakay Ö, Alp A. Tuberculosis screening results made at primary schools in Cizre. Tüberk Toraks 2006; 54: 336-40.
  • Özşahin SL, Akkurt İ, Berk S. Tuberculin skin test results of 10 year screening in Sivas tuberculosis prevention and treatment center.13th National Tuberculosis and Chest Disease Congress. Malatya, 3-5 April 2003.
  • Bozkanat E, Çift çi F, Apaydın M, Kartaloğlu Z, Tozkoparan E, Deniz Ö et al. Tuberculin skin test screening in a military school in İstanbul city center. Tüberk Toraks 2005; 53: 39-49.
  • Gundogdu Z, Aydogan M, Arisoy ES, Gokalp AS. Eff ect of number of BCG vaccination on tuberculin induration size. J of Paediatr and Child Health 2007; 43: 476-9.
  • Ildirim I, Hacimustafaoğlu M, Ediz B. Correlation of tuberculin induration with the number of Bacillus Calmette-Guerin vaccines. Pediatr Infect Dis J 1995; 14: 1060-3.
  • Gounder CR, Driver CR, Scholten JN, Shen H, Munsiff SS. Tuberculin testing and risk of tuberculosis infection among New York City school children. Pediatrics 2003; 111: 309-15.
  • Driver CR, Valway SE, Cantwell MF, Onorato IM. Tuberculin skin test screening in schoolchildren in the United States. Pediatrics 1996; 98: 97-102.
  • Scholten JN, Fujiwara PI, Frieden TR. Prevalence and factors associated with tuberculosis infection among new school entrants, New York City, 1991-1993. Int J Tuberc Lung Dis 1999; 3: 31-41.
  • Sterne JA, Fine PE, Ponnighaus JM, Sibanda F, Munthali M, Glynn JR. Does bacille Calmette-Guerin scar size have implications for protection against tuberculosis or leprosy? Tuber Lung Dis 1996; 77: 117-23.
  • Wilson R. Tuberculosis, ERS Monograph. Bacille Calmette- Guérin vaccination in the 21st century. UK; 1997. p.327-47.
  • Ifezulike CC, Ezechukwu CC, Egbonu I, Chukwuka JO. Tuberculin reaction among healthy BCG vaccinated primary school, children in Nnewi, south eastern Nigeria. Niger J Clin Pract 2005; 8: 4-9.
Turkish Journal of Medical Sciences-Cover
  • ISSN: 1300-0144
  • Yayın Aralığı: Yılda 6 Sayı
  • Yayıncı: TÜBİTAK
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