ABSTRACT
The tuberculin skin test [TST] is a widely used diagnostic test, but its interpretation depends on the cut-off used for positivity. This study determined the threshold value of positivity of TST when screening for tuberculosis infection and when directly diagnosing tuberculosis disease. We conducted a prospective study over 2 years among 174 patients with confirmed tuberculosis and 205 healthy controls recruited at Moulay Youssef Hospital, Rabat, Morocco. Participants underwent the TST and the diameter of induration was measured after 72 hours. A second reading was made after 5 and 7 days in patients > 65 years when the test was negative. Using the ROC curve we determined 2 thresholds of positivity for TST: 9 mm had a 68% sensitivity and 78% specificity, and 13 mm a 54% sensitivity and 90% specificity. Thus 9 mm is sufficient to diagnose tuberculosis infection, but 13 mm is needed to diagnose tuberculosis disease
Subject(s)
Humans , Male , Female , Tuberculosis , Prospective StudiesABSTRACT
It is a problem of public health, its prevalence is estimated at 300 millions people around the world, its clinical features diagnostic and therapeutic are very heterogeneous with age, then constitute a difficult task. This is a retrospective comparative study of 81 asthmatics profile divided into 2G + and G2: those over 65 years [GI] subjects under 65 years [G2]. The female is found in both groups, the average age was 69 ans +/- 14 versus 21 years +/- 10 in 1 and 2. In the personal history, it was noted that in patients under age 65 [group 2] there was more of rhinitis and dermatitis, but less of conjunctivitis and this statistically significant [p = 0.001]. Smoking is only found in 7%: 4 patients in G2 and 1 in G1. obesity is found in 64% in G2 versus 29.4% in the first group Aggravating obstructive disease is more frequent in G2, when we had moderate to severe obstruction in the group over 65 years [GI]. Exacerbations were more severe in G1 [17.6% versus 12.5%]. Control was total in group 2 and poor or partial in G1. compared to G2 [under 65 years], elderly asthmatics are more conjunctivitis, more smoking not obese with FEV and PEF lowest, more severe exacerbations and the control is poor or partial. This study suggests that elderly patients, have difficult problems for the diagnostic and therapeutic. The first difficulty is identification of asthma. The second difficulty concerns the monitoring of these patients: the pulmonary function is more difficult to achieve with a relative irreversibility of obstructive, the third difficulty is a problem understanding and observance of the regimen and a control, or to interest to pay particular attention in the elderly asthmatics for maintaining a quality of living