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Tuberculosis screening and anergy in a homeless population
1Residency Program in Family Practice, St Joseph's Medical Center, Yonkers, NY, USA.
The Journal of the American Board of Family Practice
|January 1, 1997
Summary
Tuberculosis screening using purified protein derivative (PPD) skin testing is accurate for homeless individuals, except for those who are also positive for human immunodeficiency virus (HIV). Anergy testing did not improve PPD accuracy in this population.
Area of Science:
- Public Health
- Infectious Diseases
- Immunology
Background:
- Tuberculosis (TB) is a growing public health issue in the U.S.
- Homeless individuals face increased TB risk factors and potential immunodeficiency.
- Immunodeficiency can lead to false-negative results in standard tuberculosis screening using purified protein derivative (PPD) skin testing.
Purpose of the Study:
- To evaluate the accuracy of PPD skin testing for tuberculosis screening in a homeless population.
- To determine if anergy status influences PPD test accuracy in this demographic.
Main Methods:
- A cohort of 105 homeless or formerly homeless individuals were tested using PPD and three other antigens (candidin, mumps, trichophytin).
- The Mantoux method was used for intradermal administration.
- Anergy was defined as a delayed-type hypersensitivity reaction of ≤2 mm to all four antigens.
Main Results:
- Of 100 participants who completed the study, 5% were found to be anergic.
- All anergic individuals (5) were previously diagnosed with human immunodeficiency virus (HIV).
Conclusions:
- Purified protein derivative (PPD) skin testing is an accurate tuberculosis screening method for the homeless population.
- PPD testing accuracy is compromised in individuals who are positive for human immunodeficiency virus (HIV).