title: Tuberculin skin testing in BCG-vaccinated populations of adults and children at high risk for tuberculosis in Taiwan.
abstract: METHODS
  Various populations at high risk for tuberculosis (TB) infection and with high bacille Calmette-Guérin (BCG) vaccination coverage in eastern Taiwan.
  
  
  OBJECTIVE
  To investigate the usefulness of the tuberculin skin test (TST) to diagnose TB in BCG-vaccinated populations.
  
  
  METHODS
  Cross-sectional survey.
  
  
  RESULTS
  TST reaction size was recorded for 444 individuals ranging in age from 8 months to 99 years, of whom 94.3% had scars to suggest previous BCG vaccination. The TST-positive (> or =10 mm) rate was increased in all comparisons of higher to lower TB risk, including household contacts (relative risk [RR] 3.52, P < 0.0001) and intermediate risk residents (RR 2.30, P = 0.030) compared to a lower risk control group. Advancing age was generally associated with increases in the TST-positive rate. Gender or the number of BCG vaccinations had no relation to the TST-positive rate.
  
  
  CONCLUSIONS
  The results of this survey suggest that in eastern Taiwan a positive TST represents either active or latent TB infection rather than past BCG vaccination. Therefore, high BCG vaccination coverage in this region does not appear to limit the usefulness of the TST as a tool for diagnosing TB.
authors.affiliation: Department of Community Health, Mennonite Christian Hospital, Hualien, Taiwan. ron_bowerman@sil.org
authors.forename: R J
authors.initials: RJ
authors.lastname: Bowerman
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001500:BCG Vaccine; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D012737:Sex Factors; D013624:Taiwan; D014374:Tuberculin Test; D014376:Tuberculosis / Q000175:diagnosis* / Q000517:prevention & control / Q000635:transmission; D014611:Vaccination
chemical_list: D001500:BCG Vaccine