PMID- 21892936
OWN - NLM
STAT- MEDLINE
DCOM- 20120111
LR  - 20240417
IS  - 1471-2458 (Electronic)
IS  - 1471-2458 (Linking)
VI  - 11
DP  - 2011 Sep 5
TI  - An evaluation of factors associated with taking and responding positive to the 
      tuberculin skin test in individuals with HIV/AIDS.
PG  - 687
LID - 10.1186/1471-2458-11-687 [doi]
AB  - BACKGROUND: The tuberculin skin test (TST) is still the standard test for 
      detecting latent infection by M tuberculosis (LTBI). Given that the Brazilian 
      Health Ministry recommends that the treatment of latent tuberculosis (LTBI) 
      should be guided by the TST results, the present study sets out to describe the 
      coverage of administering the TST in people living with HIV at two referral 
      health centers in the city of Recife, where TST is offered to all patients. In 
      addition, factors associated with the non-application of the test and with 
      positive TST results were also analyzed. METHODS: A cross-sectional study was 
      carried out with HIV patients, aged 18 years or over, attending outpatient 
      clinics at the Correia Picanco Hospital/SES/PE and the Oswaldo Cruz/UPE 
      University Hospital, who had been recommended to take the TST, in the period 
      between November 2007 and February 2010. Univariate and multivariate logistic 
      regression analyses were carried out to establish associations between the 
      dependent variable - taking the TST (yes/no), at a first stage analysis, and the 
      independent variables, followed by a second stage analysis considering a positive 
      TST as the dependent variable. The odds ratio was calculated as the measure of 
      association and the confidence interval (CI) at 95% as the measure of accuracy of 
      the estimate. RESULTS: Of the 2,290 patients recruited, 1087 (47.5%) took the 
      TST. Of the 1,087 patients who took the tuberculin skin test, the prevalence of 
      TST >/= 5 mm was 21.6% among patients with CD4 >/= 200 and 9.49% among those with CD4 
      < 200 (p = 0.002). The patients most likely not to take the test were: men, 
      people aged under 39 years, people with low educational levels and crack users. 
      The risk for not taking the TST was statiscally different for health service. 
      Patients who presented better immunity (CD4 >/= 200) were more than two and a half 
      times more likely to test positive that those with higher levels of 
      immunodeficiency (CD4 < 200). CONCLUSIONS: Considering that the TST is 
      recommended by the Brazilian health authorities, coverage for taking the test was 
      very low. The most serious implication of this is that LTBI treatment was not 
      carried out for the unidentified TST-positive patients, who may consequently go 
      on to develop TB and eventually die.
FAU - Moura, Libia C R V
AU  - Moura LC
AD  - Department of Tropical Medicine, Universidade Federal de Pernambuco, Recife, 
      Brazil. mouralibia@gmail.com
FAU - Ximenes, Ricardo A A
AU  - Ximenes RA
FAU - Ramos, Heloisa L
AU  - Ramos HL
FAU - Miranda Filho, Democrito B
AU  - Miranda Filho DB
FAU - Freitas, Carolina D P
AU  - Freitas CD
FAU - Silva, Rosangela M S
AU  - Silva RM
FAU - Coimbra, Isabella
AU  - Coimbra I
FAU - Batista, Joanna d'Arc L
AU  - Batista Jd
FAU - Montarroyos, Ulisses R
AU  - Montarroyos UR
FAU - Militao Albuquerque, Maria de Fatima P
AU  - Militao Albuquerque Mde F
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20110905
PL  - England
TA  - BMC Public Health
JT  - BMC public health
JID - 100968562
SB  - IM
MH  - Adult
MH  - Age Factors
MH  - Brazil
MH  - Cross-Sectional Studies
MH  - Female
MH  - HIV Infections/*complications
MH  - Humans
MH  - Latent Tuberculosis/complications/*diagnosis
MH  - Male
MH  - Patient Acceptance of Health Care/*statistics & numerical data
MH  - Sex Factors
MH  - Socioeconomic Factors
MH  - Tuberculin Test/*statistics & numerical data
PMC - PMC3223927
EDAT- 2011/09/07 06:00
MHDA- 2012/01/12 06:00
PMCR- 2011/09/05
CRDT- 2011/09/07 06:00
PHST- 2011/01/24 00:00 [received]
PHST- 2011/09/05 00:00 [accepted]
PHST- 2011/09/07 06:00 [entrez]
PHST- 2011/09/07 06:00 [pubmed]
PHST- 2012/01/12 06:00 [medline]
PHST- 2011/09/05 00:00 [pmc-release]
AID - 1471-2458-11-687 [pii]
AID - 10.1186/1471-2458-11-687 [doi]
PST - epublish
SO  - BMC Public Health. 2011 Sep 5;11:687. doi: 10.1186/1471-2458-11-687.