title: Screening for latent tuberculosis in refugees with renal failure.
abstract: Refugee camps are prone for easy spread of infections of various kinds and tuberculosis (TB) is no exception. Refugees with renal failure are often a vulnerable group because they are immunocompromised due to reasons such as poor nutrition, overcrowding and immune suppression due to renal failure. Latent pulmonary TB is a particular problem in this patient population as it is not easily diagnosed and has immense potential for spread. Tuberculin Skin Test (TST), although easy to perform and is cost-effective, suffers from the limitations of giving false positive results due to cross-reaction with the vaccination. Chest radiography though cheap, has not yet been validated in refugee populations for this purpose. Sputum analysis shows promise due to ease of performing but again has not been validated in refugees. Newer assays such as IF-γ show great promise but needs large scale studies for validation and cheaper assays need to be developed for use in resource poor refugee setting. In short, an ideal tool for effective screening of latent TB in refugees with renal failure is lacking. Future studies are required to identify this ideal tool.
authors.affiliation: Department of General Medicine, Sri Ramachandra University, Chennai, India. gpalaman@jhsph.edu
authors.forename: Ghanshyam Palamaner Subash
authors.initials: GP
authors.lastname: Shantha
authors.forename: Anita Ashok
authors.initials: AA
authors.lastname: Kumar
authors.forename: Viraj
authors.initials: V
authors.lastname: Bhise
authors.forename: Kamesh
authors.initials: K
authors.lastname: Sivagnanam
authors.forename: Kuyilan Karai
authors.initials: KK
authors.lastname: Subramanian
authors.forename: Pushkar
authors.initials: P
authors.lastname: Kanade
authors.forename: Rohit
authors.initials: R
authors.lastname: Khanna
mesh_terms: D001431:Bacteriological Techniques; D058501:Enzyme-Linked Immunospot Assay; D006801:Humans; D055985:Latent Tuberculosis / Q000175:diagnosis* / Q000453:epidemiology / Q000382:microbiology / Q000635:transmission; D008403:Mass Screening / Q000379:methods; D009169:Mycobacterium tuberculosis / Q000302:isolation & purification; D011237:Predictive Value of Tests; D013902:Radiography, Thoracic; D012036:Refugees; D051437:Renal Insufficiency / Q000453:epidemiology*; D013183:Sputum / Q000382:microbiology; D014374:Tuberculin Test; D035862:Vulnerable Populations