Tuberculin Skin Test Result and Risk of Death among Persons with Active TB

Details

• Alternative Title:
  PLoS One
• Personal Author:
  Auld, Sara C. ; Click, Eleanor S. ; Heilig, Charles M. ; Miramontes, Roque ; Cain, Kevin P. ; Bisson, Gregory P. ; Kenzie, William R. Mac.
• Description:
  Background
  
  Although the tuberculin skin test (TST) is frequently used to aid in the diagnosis of tuberculosis (TB) disease and to identify persons with latent TB infection, it is an imperfect test and approximately 10–25% of persons with microbiologically confirmed TB disease have a negative TST. Previous studies have suggested that persons with a negative TST are more likely to present with severe TB disease and have an increased rate of TB-related death.
  
  Methods
  
  We analyzed culture-confirmed TB cases captured in US TB surveillance data from 1993 to 2008 and performed multivariate logistic regression analysis to determine the association between TST result and death.
  
  Results
  
  Of 284,866 cases of TB reported in the US, 58,180 persons were eligible for inclusion in the analysis and 3,270 of those persons died after initiating TB treatment. Persons with a negative TST accounted for only 14% of the eligible cases but accounted for 42% of the deaths. Persons with a TST≥15 mm had 67% lower odds of death than persons with a negative TST (adjusted odds ratio 0.33, 95% confidence interval 0.30–0.36).
  
  Conclusions
  
  A negative TST is associated with an increased risk of death among persons with culture-confirmed TB disease, even after adjustment for HIV status, site of TB disease, sputum smear AFB status, drug susceptibility, age, sex, and origin of birth. In addition to indicating risk of developing disease, the TST may also be a marker for increased risk of death.
  
  
• Subjects:
  Adult Aged Aged, 80 And Over Child Child, Preschool Female Humans Infant Male Middle Aged Retrospective Studies Risk Factors Tuberculin Test Tuberculosis

  More +
• Source:
  PLoS One. 2013; 8(11).
• Document Type:
  Journal Article
• Volume:
  8
• Issue:
  11
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:85d07f86d7fb5795b414c4db91eb208543d6edbc2330227ef16d73d3c6fca4ba
• Download URL:
  https://stacks.cdc.gov/view/cdc/21225/cdc_21225_DS1.pdf
• File Type:
  [PDF - 393.00 KB ]