Conversion of tuberculin skin test in adults

Tuberculosis is a major public health hazard. The tuberculin skin test is one of the diagnostic tools in this regard. Since BCG vaccination is performed during infancy in Iran, a positive tuberculin skin test [PPD] may confuse the physician. For this reason we performed this study on adults. A descriptive study was performed on 433 soldiers between 2006 and 2007. Demographic data like age, level of education, family history of tuberculosis, place of residence, cigarette smoking, and chronic cough for more than 3 weeks, were collected from each patient. All patients had a history of BCG vaccination during infancy and its scar was detected in all of them. Purified protein derivative [PPD] test was performed. A 0.1 ml of 5TU PPD solution was injected intradermally into the volar face of the forearm and after 72h transverse diameter of the induration was measured in millimeters with a transparent ruler. Induration size greater than l0mm was considered a positive reaction. All patients were followed for one year and participated again in the second phase of PPD injection after one year. Data were analyzed by using SPSS software ver.13. Paired t-test and Chi-square test were used for statistical evaluation. All soldiers were male with a mean age of 23.2 +/- 1.8 yrs. Twenty-three cases [5.3%] had positive tuberculin skin tests after one year. The highest level of education was high school diploma in 288 soldiers [66.5%]. There was no significant correlation between the educational background and positivity of the tuberculin skin test [p = 0.219]. Twenty-two cases [5%] had a history of cigarette smoking which was significantly related to positive tuberculin skin tests [p=0.001]. There was chronic cough in 44 [10.6%] soldiers which did not have any significant correlation with tuberculin skin test results [p = 0.6]. This study showed that the prevalence of new cases of tuberculosis was more than 5% per year. Therefore, performing tuberculin skin test in BCG vaccinated adults is important

Seroepidemiology of hepatitis A virus in Iranin soldiers in 2006: Do they need vaccination?

Since hepatitis A virus is a contagious viral infection, crowded military quarters are a fertile ground for the spread of this disease. This study sought to evaluate immunity against hepatitis A virus among Iranian military draftees so as to determine whether or not universal vaccination for the armed forces is necessary. This cross-sectional study randomly selected 800 army draftees in Tehran, the capital city of Iran in 2006. Demographic data, namely age, occupation before call-up, education, and time of in-service, were collected. Five ml of blood was taken from all the subjects; the blood samples were then centrifuged and their serum was examined by the Elisa test with a broad test of Abbott-hepatitis A virus AB META-AXSYM system for total hepatitis A virus antibody. The data were subsequently analyzed with SPSS software, t-test, and Mann-Whitney's test. P<0.05 was considered significant. All the 800 soldiers were male with a mean age of 19 +/- 1SD years, and 702 [88%] of them were holders of a high school diploma with the rest being school dropouts. 781[97.63%] of the subjects had anti-hepatitis A virus antibody while the other 19 [2.37%] did not. That 97.63% of the army draftees recruited into our study were immune to hepatitis A virus is an indication that vaccination for hepatitis A is not necessary for Iranian military conscripts at this juncture

Seroepidemiology of Hepatitis E virus Inranin soldiers

Hepatitis E virus [HEV] is recognized as a common cause of epidemic and sporadic viral hepatitis. HEV outbreaks have been documented in some military forces in the world. The aim of this study was to evaluate anti-HEV antibody in Iranian soldiers. In a cross-sectional study, 800 soldiers were selected by simple random sampling in Tehran, Iran in 2006. A questionnaire of demographic data was completed and blood samples were obtained for anti-HEV IgG and IgM antibody. Data were analyzed using student t-test and chi-square using SPSS 12. All soldiers were male and their mean age was 19 +/- 1.2. Education level in 553 [69.1%] of them was high school diploma or higher. Anti-HEV IgG antibody was positive in only 9 [1.1%] of them and IgM was negative in all soldiers. Approximately 98% of soldiers were at risk for HEV infection and before discovering an effective vaccine, preparation of healthy drinking water and personal hygiene education should be considered for prevention of hepatitis E infection

Sero-Surveillance of Measles in Iranian Army Students after Nationwide Revaccination in 2004

Decay of vaccine-induced antibody titres without boosting of the wild measles virus has been well documented. Revaccination against measles has reduced the prevalence of the disease worldwide. Revaccination may cause IgE induced anaphylaxis. To study measles IgG antibody in revaccinated populations and its relation to IgE induced hypersensitivity. Blood samples were taken from 800 volunteer army students aging from 18-22 years after one month of nationwide revaccination in Tehran in the year 2004. Sera were collected and kept frozen until used. Anti-measles IgG antibody and total IgE antibody were measured by ELISA assay. Data indicated that only 2.37% of subjects were negative for measles antibody [titre less than 500] after a single dose of booster vaccination. From those individuals with positive IgG, 200 cases [25%] had antibody titres over 5000 IU/ml. The results showed a maximum IgE antibody titre of 1000 IU/ml [p<0.02] in which thirty cases [3.75%] had IgE titres over 1000 IU/ml [p<0.02]. Single vaccination against measles during childhood is not sufficient for protecting against measles virus and revaccination is needed to recall specific immunity, although like other viral infections it may trigger IgE antibody responses in a small percentage of the population

Primary tuberculous abscess of the parotid gland: a case report

Chronic parotiditis is a rare disease of the parotid glands. Both infectious [e.g. tuberculosis] and non-infectious causes [e.g. sarcoidosis, autoimmune diseases, malignancy and duct stones] have been enumerated for this condition. Primary tuberculous parotiditis is a rare disease. It was diagnosed in a 20-year-old soldier after obtaining a biopsy and observing granuloma and caseous necrosis compatible with TB in histological examination of the specimen. Cultures of discharge and tissue were negative in regard to mycobacterium tuberculosis. Also, malignancy was ruled out by histopathological examinations. Therefore, the four drug anti-TB regimen was initiated. The patient was completely treated and there was no report of recurrence. The endemic condition of TB in developing countries such as Iran has increased the rate of extra-pulmonary TB. One of the extra pulmonary sites which is rarely involved in TB is parotid gland; presenting usually as chronic swelling or mass. Therefore, it is recommended to consider TB in the differential diagnosis of parotiditis and chronic swelling of this salivary gland especially in developing countries