Alexandre Daronco

Comparação do teste tuberculínico e do ensaio de liberação de interferon-gama para diagnóstico de tuberculose latente em agentes comunitários de saúde do Sul do Brasil, Rio Grande do Sul, 2012

OBJETIVO:comparar a capacidade de deteccao de infeccao latente por Mycobacterium tuberculosis em agentes comunitarios de saude (ACS) com uso do teste tuberculinico (TT) e do ensaio de liberacao de interferon-gama (IGRA).METODOS:estudo transversal realizado no municipio de Santa Cruz do Sul, Rio Grande do Sul, Brasil, com aplicacao do TT e do IGRA em 47 ACS no periodo de marco a junho de 2012; o TT foi considerado positivo na presenca de uma induracao ≥10 mm, assim como o IGRA, se houvesse concentracao ≥0,35 UI/ml de interferon-gama.RESULTADOS:12 ACS apresentaram TT positivo e 6 tiveram IGRA positivo; a concordância entre os testes foi avaliada como pobre (κ=0,063).CONCLUSAO:apesar do numero limitado de amostras, a alta discordância entre os testes evidencia a necessidade de desenvolver mais estudos que busquem encontrar uma explicacao biologica para tais diferencas e avaliem a relacao de custo-beneficio na utilizacao do IGRA.Objective: to compare the ability to detect latent Mycobacterium tuberculosis infection among community health workers using the tuberculin skin test (TST) and Interferon-gamma release assay (IGRA). Methods: this was a cross-sectional study conducted in Santa Cruz do Sul-RS, Brazil, applying TST and IGRA to 47 community health workers between March and June 2012. TST was considered positive when induration was ≥10mm. IGRA was considered positive when interferon-gama concentration was at least 0.35 IU/mL. Results: 12 community health workers presented positive TST and 6 had positive IGRA, the agreement between the tets was considered poor (k=0.063). Conclusion: despite the limited number of samples there is a high discrepancy between the tests, what emphasize the need for more studies to find a biological explanation for these differences and to examine the cost-benefit of using IGRA.

Prevalência de infecção latente por mycobacterium tuberculosis em profissionais da rede básica de saúde

Objective: To estimate the prevalence of latent M. tuberculosis infection and identify characteristics related to latent infection among workers of the primary healthcare network.Methods: Cross-sectional, observational and descriptive study, conducted in 2011, included 137 basic health workers who performed their activities in a municipality. Interviews were carried out addressing characteristics of exposure at work (BCG vaccination, length of time working in the health system, potential exposure to tuberculosis, HIV infection, use of corticosteroids, diabetes, use of tobacco or alcohol) and subsequently performed tuberculin skin test (TST). Data was analyzed with Fischer and Student’s t-test (p < 0.05). Results: Health professionals were mostly women (n=126, 92%) with mean age of 35.3 (± 9.1) years. Among the reactors, 25 (55.5%) sought medical care, and of these, 7 (28%) underwent prophylactic treatment. The prevalence of latent tuberculosis was 32.8%. Of the characteristics evaluated, only smoking (OR 3.03; 95%CI 1.05-8.77) was associated with latent infection. Conclusion: The estimated prevalence of latent M. tuberculosis infection among the evaluated health workers was 32.8%. As for the characteristics studied, it was not possible to relate them to latent infection among workers in primary healthcare network, with the exception of the smoking habit. doi: 10.5020/18061230.2014.p269

Comparison of tuberculin test and interferon-gamma release assay for diagnosing latent tuberculosis in Community Health Workers, State of Rio Grande do Sul, Brazil, 2012

OBJETIVO:comparar a capacidade de deteccao de infeccao latente por Mycobacterium tuberculosis em agentes comunitarios de saude (ACS) com uso do teste tuberculinico (TT) e do ensaio de liberacao de interferon-gama (IGRA).METODOS:estudo transversal realizado no municipio de Santa Cruz do Sul, Rio Grande do Sul, Brasil, com aplicacao do TT e do IGRA em 47 ACS no periodo de marco a junho de 2012; o TT foi considerado positivo na presenca de uma induracao ≥10 mm, assim como o IGRA, se houvesse concentracao ≥0,35 UI/ml de interferon-gama.RESULTADOS:12 ACS apresentaram TT positivo e 6 tiveram IGRA positivo; a concordância entre os testes foi avaliada como pobre (κ=0,063).CONCLUSAO:apesar do numero limitado de amostras, a alta discordância entre os testes evidencia a necessidade de desenvolver mais estudos que busquem encontrar uma explicacao biologica para tais diferencas e avaliem a relacao de custo-beneficio na utilizacao do IGRA.Objective: to compare the ability to detect latent Mycobacterium tuberculosis infection among community health workers using the tuberculin skin test (TST) and Interferon-gamma release assay (IGRA). Methods: this was a cross-sectional study conducted in Santa Cruz do Sul-RS, Brazil, applying TST and IGRA to 47 community health workers between March and June 2012. TST was considered positive when induration was ≥10mm. IGRA was considered positive when interferon-gama concentration was at least 0.35 IU/mL. Results: 12 community health workers presented positive TST and 6 had positive IGRA, the agreement between the tets was considered poor (k=0.063). Conclusion: despite the limited number of samples there is a high discrepancy between the tests, what emphasize the need for more studies to find a biological explanation for these differences and to examine the cost-benefit of using IGRA.

Comparación de la prueba de tuberculina y del ensayo de liberación de interferón gamma para diagnóstico de tuberculosis latente en agentes comunitarios de salud del Sur de Brasil, Rio Grande do Sul, 2012

OBJETIVO:comparar a capacidade de deteccao de infeccao latente por Mycobacterium tuberculosis em agentes comunitarios de saude (ACS) com uso do teste tuberculinico (TT) e do ensaio de liberacao de interferon-gama (IGRA).METODOS:estudo transversal realizado no municipio de Santa Cruz do Sul, Rio Grande do Sul, Brasil, com aplicacao do TT e do IGRA em 47 ACS no periodo de marco a junho de 2012; o TT foi considerado positivo na presenca de uma induracao ≥10 mm, assim como o IGRA, se houvesse concentracao ≥0,35 UI/ml de interferon-gama.RESULTADOS:12 ACS apresentaram TT positivo e 6 tiveram IGRA positivo; a concordância entre os testes foi avaliada como pobre (κ=0,063).CONCLUSAO:apesar do numero limitado de amostras, a alta discordância entre os testes evidencia a necessidade de desenvolver mais estudos que busquem encontrar uma explicacao biologica para tais diferencas e avaliem a relacao de custo-beneficio na utilizacao do IGRA.Objective: to compare the ability to detect latent Mycobacterium tuberculosis infection among community health workers using the tuberculin skin test (TST) and Interferon-gamma release assay (IGRA). Methods: this was a cross-sectional study conducted in Santa Cruz do Sul-RS, Brazil, applying TST and IGRA to 47 community health workers between March and June 2012. TST was considered positive when induration was ≥10mm. IGRA was considered positive when interferon-gama concentration was at least 0.35 IU/mL. Results: 12 community health workers presented positive TST and 6 had positive IGRA, the agreement between the tets was considered poor (k=0.063). Conclusion: despite the limited number of samples there is a high discrepancy between the tests, what emphasize the need for more studies to find a biological explanation for these differences and to examine the cost-benefit of using IGRA.