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Free Content Tuberculin reactivity and the risk of tuberculosis: a review

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SETTING: Although various studies have examined the association between tuberculin reactivity and the risk of tuberculosis (TB), this evidence has not been collated and examined to determine the strength and consistency of the association across multiple studies.

OBJECTIVE: To review the evidence supporting the association between tuberculin reactivity and the risk of TB.

DESIGN: Prospective studies which included raw data on the incidence of TB according to three or more tuberculin reactor categories were located using electronic search methods. The findings of these studies were recalibrated if necessary and compared.

RESULTS: All 11 studies identified demonstrated that increased tuberculin skin test (TST) reactivity was associated with an increased risk of TB, and several found that low tuberculin reactivity was associated with a protective effect. The magnitude of the association between TST reactivity and the risk of TB varied substantially. The association between tuberculin reactivity and the risk of TB was greater among studies that reported a lower incidence of TB among the smallest tuberculin reactor category.

CONCLUSION: All studies reviewed support a positive association between tuberculin reactivity and the risk of TB. However, this review found a substantial degree of variation in the extent of increased risk associated with larger tuberculin reactions.
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Keywords: risk; tuberculin skin test; tuberculosis

Document Type: Review Article

Affiliations: Department of Public Health, The University of Western Australia, Nedlands, Western Australia

Publication date: October 1, 2000

More about this publication?
  • 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 lung health world-wide.

    To share scientific research of immediate concern as rapidly as possible, The Union is fast-tracking the publication of certain articles from the IJTLD and publishing them on The Union website, prior to their publication in the Journal. Read fast-track articles.

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

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