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False-positive tuberculin skin tests in a state prison system
J C Grabau1, S E Hughes, E A Foster
1Bureau of Tuberculosis Control, New York State Department of Health, Albany, New York 12237-0669, USA. jcg07@health.state.ny.us
Switching tuberculin skin test (TST) products led to false positives. Retesting revealed 40.8% of positive TST results were actually negative, highlighting product variability in TB infection testing.
Area of Science:
- Public Health
- Infectious Disease Epidemiology
- Medical Diagnostics
Background:
- Tuberculin skin test (TST) is crucial for diagnosing tuberculosis (TB) infection.
- Variability in TST products and administration can impact test accuracy.
- A prison system switched from Tubersol to Aplisol for TST due to product shortage.
Purpose of the Study:
- To evaluate the occurrence and magnitude of false-positive TST results after changing to a different testing product.
- To assess the impact of switching TST manufacturers on TB infection detection rates.
Main Methods:
- Over 9300 inmates in a state prison system underwent routine annual TST.
- A switch from Tubersol to Aplisol was implemented for TST.
- Inmates with positive TST results (≥5 mm) using Aplisol were retested with Tubersol in 34 prisons.
Main Results:
- Out of 368 inmates initially testing positive with Aplisol (≥5 mm), 150 (40.8%) tested negative (0-4 mm) upon retesting with Tubersol.
- This indicates a significant rate of false-positive TST results associated with the Aplisol product.
Conclusions:
- The tuberculin skin test (TST) is a valuable diagnostic tool for TB infection.
- Inconsistencies between TST lots and manufacturers can lead to errors in determining infection status.
- Clinical and epidemiological context is essential when interpreting TST results, which should not be considered definitive.
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