PPD RT23 for tuberculin surveys in India CHADHA, V. K; JAGANNATHA, P. S; VAIDYANATHAN, P. S ...
The international journal of tuberculosis and lung disease,
02/2003, Letnik:
7, Številka:
2
Journal Article
Recenzirano
SETTING: Tuberculosis sanatoria and villages in Bangalore district.OBJECTIVES: To study the appropriateness of continuing to use 1TU dilutions prepared by the BCG Laboratory, Guindy, in Chennai, ...India, from a freeze-dried form of PPD RT23 with Tween 80 received from Statens Serum Institut (SSI), Copenhagen, for tuberculin surveys in India.DESIGN: The responses to dual tuberculin tests were compared among: 1) 63 smear-positive cases using 2TU PPD prepared by the Guindy laboratory (Dilution-G), and 2TU PPD prepared by the SSI (Dilution-S); 2) 124 smear-positive cases using 1TU and 2TU Dilution-G; and 3) 1338 apparently healthy children using 1TU and 2TU Dilution-G. Test sites were allocated randomly using the double-blind technique. Tuberculin responses obtained during studies conducted in India and in other countries were compared.RESULTS: The differences in sensitivity of tuberculin testing using the different preparations were found to be small and statistically non-significant. Among children, a higher proportion of reaction sizes in 10-14 mm and 15+ mm categories was observed to 2TU compared to 1TU of Dilution-G. This could reflect lower specificity of 2TU in the study area where non-specific sensitivity is highly prevalent. Studies in India and other countries do not suggest any loss in potency of 1TU PPD RT23 with Tween 80.CONCLUSION: 1TU dilutions of PPD RT23 with Tween 80 provided by the BCG Laboratory, Guindy, may continue to be used for tuberculin surveys in India.
OBJECTIVE: To estimate the annual risk of tuberculosis infection (ARTI) among children aged 1-9 years in the south zone of India.SETTING: The survey was carried out in a representative sample of ...villages and census enumeration blocks of towns in four south Indian states, as a part of a nationwide tuberculin survey.DESIGN: Six districts were selected through systematic random sampling. Four hundred and twenty rural clusters and 180 urban clusters were selected from these districts on the basis of the rural-urban ratio in the entire zone. To obtain the required sample of 12000 children without bacille Calmette-Guérin (BCG) vaccination, 51000 had to be covered. Eighty-five children from each cluster were tuberculin tested and read for reaction sizes. The ARTI was computed from the estimated prevalence of TB infection among children without a BCG scar.RESULT: Among 52951 children registered for the study, 50846 (96%) had a tuberculin test result. The BCG coverage for the study population was about 65%. Among 17811 children without a BCG scar, the prevalence of infection was 5.9% (95%CI 4.0-7.7%); the corresponding ARTI was 1.7% (95%CI 0.7-1.4%).CONCLUSION: The estimated ARTI for the south zone is 1.0%, as compared to the national average of 1.7% used for programme evaluation. This baseline information should be useful for the assessment of future trends.
This Supplement provides an update on guidelines first published in 1996 on conducting a tuberculin skin test survey and analyzing the resulting data. The updated guidelines add experiences gained ...from community surveys, revisit the proposed sampling strategies, and provide additional
information on ethical considerations.
SETTING: Rural and urban areas of eight selected districts in the eastern zone of India.OBJECTIVES: To estimate the annual risk of tuberculous infection (ARTI).STUDY DESIGN: A community-based, ...cross-sectional tuberculin survey was conducted among children aged 1-9 years residing in a sample of rural and urban areas. Stratified two-stage cluster sampling was adopted for selection of rural and urban clusters. A total of 40964 children in 515 clusters underwent tuberculin testing and reading with 1TU PPD RT23 with Tween 80; the maximum transverse diameter of induration was measured about 72 h after the test.RESULTS: A bacille Calmette-Guérin (BCG) scar was observed in 51.5% of the test-read children. The frequency distribution of tuberculin reaction size among 19332 children without BCG scar was found to be bimodal, with the mode of reactions attributable to infection with tubercle bacilli at 20 mm. The prevalence of infection was estimated as 6.9%. The ARTI computed from the estimated prevalence was 1.3%. Children residing in the urban areas were found to be at a significantly higher risk of infection than those residing in rural areas.CONCLUSION: The high rate of ARTI in the eastern zone of India suggests a need for committed, sustained action in provision of quality tuberculosis control services.
A total of 112 cases (New = 101, previously treated = 11) were diagnosed as suffering from tuberculosis (TB) at a private clinic in Bangalore city. The clinic identified TB suspects, established ...diagnosis of TB, administered direct observation of treatment (DOT), maintained treatment cards and undertook defaulter retrieval actions as and when required. The Revised National Tuberculosis Control Programme (RNTCP) provided support in terms of sputum microscopy supply of patient-wise drug boxes and registration of patients. Ninety six (95.1%) of new cases and 10 (90.9%) of previously treated cases had successful treatment outcome. Most patients completed treatment within the prescribed period. No TB deaths were reported during the period of treatment.
SETTING: Rural and urban areas of six selected districts in the western zone of India.OBJECTIVES: To estimate the annual risk of tuberculous infection (ARI).DESIGN: A community-based, cross-sectional ...tuberculin survey was conducted among children aged 1-9 years residing in a sample of rural and urban areas of six districts in the western zone of India. Stratified two-stage cluster sampling was adopted for selection of rural and urban clusters. A total of 48473 children in 600 clusters underwent tuberculin testing with 1TU PPD RT23 with Tween 80; the induration was measured about 72 h after the test.RESULTS: The BCG scar was observed in 52% of the test-read children. Estimation of the prevalence of infection was based on the frequency distribution of tuberculin reaction size among 22259 children without BCG scar. Reactions ≥15 mm were considered attributable to infection with tubercle bacilli. The prevalence of infection was estimated to be 9.3%, and the ARI computed from the estimated prevalence was 1.8%. The proportion of infected children was found to be significantly higher in urban than in rural areas.CONCLUSION: The high rate of ARI in the western zone of India calls for further intensification of tuberculosis control efforts.
SETTING: Rural and urban areas of eight selected districts of Orissa State, India.OBJECTIVES: To estimate the average annual risk of tuberculous infection (ARTI) in the state.DESIGN: A ...community-based, cross-sectional tuberculin survey was conducted among children aged 1-9 years residing in a sample of rural and urban areas of eight districts of Orissa State. A stratified sampling was adopted for selection of clusters. Highly trained designated tuberculin testers administered 0.1 ml (1 TU) of PPD RT 23 with Tween 80 by the Mantoux method to 10626 children. Transverse tuberculin reaction sizes were measured about 72 h later by trained designated tuberculin readers. The number of children satisfactorily test-read was 10191.RESULTS: Based on the frequency distribution of tuberculin reaction sizes, the average ARTI in the state was estimated at 1.7-1.8%. The children residing in urban areas were observed to be at a significantly higher risk of infection than those in rural areas.CONCLUSION: The study in Orissa State suggests high rates of transmission of tuberculous infection and calls to attention the need for intensification of concerted and sustained tuberculosis control efforts.
Alzheimer's disease (AD) is characterized by high heterogeneity in disease manifestation, progression and risk factors. High phenotypic variability is currently regarded as one of the largest hurdles ...in early diagnosis and in the design of clinical trials; there is therefore great interest in identifying factors driving variability that can be used for patient stratification. In addition to genetic and lifestyle factors, the individual's sex and gender are emerging as crucial drivers of phenotypic variability. Evidence exists on sex and gender differences in the rate of cognitive deterioration and brain atrophy, and in the effect of risk factors as well as in the patterns of diagnostic biomarkers. Such evidence might be of high relevance and requires attention in clinical practice and clinical trials. However, sex and gender differences are currently seldom appreciated; importantly, consideration of sex and gender differences is not currently a focus in the design and analysis of clinical trials for AD. The objective of this position paper is (i) to provide an overview of known sex and gender differences that might have implications for clinical practice, (ii) to identify the most important knowledge gaps in the field (with a special regard to clinical trials) and (iii) to provide conclusions for future studies. This scientific statement is endorsed by the European Academy of Neurology.
A real-time RT-PCR assay was standardized and evaluated for the detection of the recent pandemic 2009 H1N1 strain that circulated around the world causing colossal loss of human life. We amplified ...the conserved regions of the hemagglutinin (HA) gene of 438 clinical specimens using real-time RT-PCR assay for rapid identification of pandemic influenza virus. The real-time RT-PCR was optimized and the primers and probes were tested against a panel of known negative and positive controls. RNA isolated from the HeLa cell line served as quality control. The conventional RT-PCR which is an established method of influenza virus diagnosis was compared to real-time RT-PCR. Of 438 clinical specimens tested, 212 specimens were found positive for influenza A virus (SD 46.669) in which 139 specimens were diagnosed positive for the pandemic 2009 H1N1 while 73 were the seasonal influenza viruses. We report that the real-time RT-PCR assay offers both, a high sensitivity and specificity when compared with the traditional identification method. The real-time RT-PCR assay allows rapid identification of the pandemic swine 2009-H1N1 at very low viral loads that are negative by the traditional RT-PCR. This optimized assay can be a very useful tool to assist both epidemiologists and the clinicians.
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