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Related Experiment Videos

Two-step tuberculin testing in a veterans domiciliary population.

J A Simon, S J McVicker, C R Ferrell

    Southern Medical Journal
    |July 1, 1983
    PubMed
    Summary

    Two-step tuberculin testing in veterans revealed a higher tuberculosis infection rate due to the booster phenomenon. This method, while effective, incurred costs slightly higher than isoniazid preventive therapy.

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    Area of Science:

    • Public Health
    • Infectious Disease Epidemiology
    • Occupational Health

    Background:

    • Tuberculin testing is crucial for tuberculosis (TB) surveillance in healthcare settings.
    • The "booster phenomenon" can inflate TB infection rates in serial testing.
    • Understanding boosting prevalence is key for accurate TB epidemiology.

    Purpose of the Study:

    • To evaluate the prevalence of the booster phenomenon in a veteran population undergoing tuberculin testing.
    • To assess the impact of two-step testing on TB infection rates.
    • To compare the costs of two-step testing with preventive therapy.

    Main Methods:

    • Employed the Mantoux test with 5 TU of purified protein derivative (PPD).
    • Re-tested non-significant reactors after one week to identify the booster effect.

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  • Collected cost data for the testing and compared with estimated preventive therapy costs.

    • Main Results:

    • Initial testing showed a 39.3% reaction rate; two-step testing increased this to 46.7%.
    • The booster phenomenon was observed in 55 of 414 subjects (13.3%), an intermediate rate.
    • Two-step testing costs marginally exceeded estimated isoniazid preventive therapy costs.

    Conclusions:

    • Two-step tuberculin testing effectively identifies additional reactors, likely due to the booster phenomenon.
    • The booster effect prevalence in this cohort was intermediate compared to other reported studies.
    • The cost-effectiveness of two-step testing warrants consideration against preventive therapy costs.