Re-Assessing Tuberculin Skin Test (TST) for the Diagnosis of Tuberculosis (TB) among African Migrants in Western Europe and USA


Background: Tuberculin skin test (TST)—is widely used for screening tuberculosis TB in migrants from high endemic countries of Africa and Asia. However, the cut-off point for clinical TB and Mtb infection is not well established in TB endemic countries of sub-Saharan Africa. In this study we compared the size of TST induration in smear positive pulmonary TB (PTB) patients, their house-hold contacts and community controls in high endemic setting in Ethiopia. Methods: In a health facility-based cross-sectional study, smear positive PTB patients were recruited. Their household contacts traced, and community controls were recruited from neighbourhoods. Sputum sample collected from patients were examined using smear microscopy. Participants were also tested by TST and QuantiFERON? -TB Gold In–Tube test (QFTGIT). Results: From a total of 224 study participants, skin test induration data were available for 48 PTB patients, 88 household contacts and 75 community controls. All 48 patients, 64 (72.2%) of the household contacts and 35 (46.7%) of the community controls had skin test induration ≥ 10 mm. Moreover, 44 (91.7%) PTB patients, 58 (65.9%) of the household contacts and 26 (34.7%) of the community controls had skin test induration ≥ 15 mm, respectively. The mean size of TST induration was significantly higher in TB patients (18.1mm) compared to that of household contacts (13.6 mm) and community controls (7.9 mm) (p< 0.001). Conclusion: Skin test induration ≥ 15 mm seems to be optimal for suspecting active TB and recommending chest X-ray for migrants from Ethiopia, and other sub-Saharan countries, while skin test induration ≥ 10 mm seems optimal to suggest Mtb infection

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Shero, K. , Legesse, M. , Medhin, G. , Belay, M. , Bjune, G. and Abebe, F. (2014) Re-Assessing Tuberculin Skin Test (TST) for the Diagnosis of Tuberculosis (TB) among African Migrants in Western Europe and USA. Journal of Tuberculosis Research, 2, 4-15. doi: 10.4236/jtr.2014.21002.

Conflicts of Interest

The authors declare no conflicts of interest.


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