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Methodological issues in the estimation of the tuberculosis problem from tuberculin surveys
1Tuberculosis Section, International Union Against Tuberculosis and Lung Disease, Paris, France.
Tubercle and Lung Disease : the Official Journal of the International Union Against Tuberculosis and Lung Disease
|April 1, 1995
Summary
Tuberculin skin test surveys are widely used for assessing tuberculosis transmission. However, accurately estimating infection prevalence and risk requires careful interpretation due to technical challenges and variability in test specificity.
Area of Science:
- Epidemiology
- Infectious Disease Control
- Public Health Surveillance
Background:
- Tuberculin skin test (TST) surveys are a primary tool for monitoring tuberculosis (TB) transmission.
- Estimating the prevalence and risk of TB infection is crucial for public health interventions.
Purpose of the Study:
- To review the operating characteristics of the TST.
- To assess the validity of estimating TB infection prevalence and risk from TST surveys.
- To identify constraints in using TST surveys to estimate the community TB burden.
Main Methods:
- Analysis of hypothetical and real data from regional and national TST surveys.
- Examination of methodological issues in TST survey conduct, analysis, and interpretation.
Main Results:
- Accurate estimation of TST infection prevalence is challenged by variable test specificity.
- Annual infection risk estimates have averaging characteristics, limiting rapid assessment of transmission changes.
- TST risk estimates do not directly standardize infectious case incidence due to intervention quality and progression rate variations.
Conclusions:
- TST surveys are valuable for long-term TB transmission assessment.
- Caution is advised when interpreting TST survey results for precise TB problem estimation.