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Free Content Simultaneous comparison of reactivity to purified protein derivative RT-23 and Tubersol® in health care workers in Vitória, Brazil [Technical Note]

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Questions have recently been raised regarding the potency of purified protein derivative (PPD) RT-23, the tuberculin most widely used world-wide for skin testing. We performed simultaneous testing with PPD RT-23 and Tubersol® to compare these reagents during a tuberculin survey of 202 adult health care workers at a large teaching hospital in 1997. Individuals were tested with 2 tuberculin units (TU) PPD RT-23 and 5 TU Tubersol® using the Mantoux method. Using a 10 mm cut-point for a positive PPD test, 39% of the health care workers were positive when tested with Tubersol® and 35% were positive when tested with PPD RT-23. The median PPD size with Tubersol® was 4 mm (interquartile range = 0–12 mm) compared to 2 mm (interquartile range = 0–12 mm) with PPD RT-23. PPD skin test reactivity with the two reagents was highly correlated (Spearman's rank coefficient, rho = 0.92; P = 0.01, two tailed). Concordance between the skin test reaction size with the two antigens did not differ based on age, sex or prior BCG vaccination. Mantoux skin test reactivity in health care workers in an area with a high prevalence of tuberculosis was comparable with PPD RT-23 and Tubersol®.
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Keywords: Tubersol®; potency; purified protein derivative; tuberculin; tuberculin RT-23

Document Type: Short Communication

Affiliations: 1: Hospital Universitário Cassiano Antônio de Moraes, Universidade Federal do Espírito Santo, Vitória, Espírito Santo, Brazil 2: Division of Infectious Diseases, Duke University Medical Center, Durham, North Carolina, USA 3: Division of Infectious Diseases, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA

Publication date: 2000-11-01

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  • The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.

    Certain IJTLD articles are selected for translation into French, Spanish, Chinese or Russian. They are available on the Union website

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