title: Changes in tuberculin skin test positivity over 20 years in periurban shantytowns in Lima, Peru.
abstract: A cross-sectional, community-based study was performed in 2012 with 428 residents of periurban shantytowns in Lima, Peru to study risk factors for and changes in latent tuberculosis infection in age-stratified groups compared with our data from the same region in 1990 (N = 219) and 2005 (N = 103). Tuberculin skin test positivity in these communities was highly prevalent at 52% overall, increased with age (P < 0.01) and was similar to 2005 (53%) and 1990 (48%). From 1990 to 2012, the prevalence of tuberculin positivity decreased in 5-14 and 15-24 year old groups (to 17% and 34%, respectively, both P < 0.05). However, this may be explained by cessation of Bacille Calmette-Guérin revaccination during this period, because Bacille Calmette-Guérin revaccination doubled tuberculin positivity. Over the same 22-year period, tuberculin positivity in the ≥ 25 year old group remained high (71%, P = 0.3), suggesting that prevalent latent tuberculosis infection persists in the adult population despite improving medical care and socioeconomic development in this region.
authors.affiliation: Global Community Health and Behavioral Sciences, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA. lmartin7@tulane.edu
authors.forename: Leonardo
authors.initials: L
authors.lastname: Martinez
authors.forename: Alyssa
authors.initials: A
authors.lastname: Arman
authors.forename: Nathan
authors.initials: N
authors.lastname: Haveman
authors.forename: Ashley
authors.initials: A
authors.lastname: Lundgren
authors.forename: Lilia
authors.initials: L
authors.lastname: Cabrera
authors.forename: Carlton A
authors.initials: CA
authors.lastname: Evans
authors.forename: Tom F
authors.initials: TF
authors.lastname: Pelly
authors.forename: Mayuko
authors.initials: M
authors.lastname: Saito
authors.forename: David
authors.initials: D
authors.lastname: Callacondo
authors.forename: Richard
authors.initials: R
authors.lastname: Oberhelman
authors.forename: Gisela
authors.initials: G
authors.lastname: Collazo
authors.forename: Andrés M
authors.initials: AM
authors.lastname: Carnero
authors.forename: Robert H
authors.initials: RH
authors.lastname: Gilman
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D055985:Latent Tuberculosis / Q000175:diagnosis* / Q000453:epidemiology* / Q000517:prevention & control; D008297:Male; D010568:Peru / Q000453:epidemiology; D015995:Prevalence; D012307:Risk Factors; D012959:Socioeconomic Factors; D014374:Tuberculin Test / Q000379:methods*; D055815:Young Adult