title: Influence of Bacille Calmette-Guérin on tuberculin skin testing in Venezuelan Amerindians in high tuberculosis burden areas.
abstract: BACKGROUND
  Extraordinarily high tuberculosis (TB) prevalence rates have been reported in Venezuelan Amerindians. Amerindian populations often live in geographically isolated villages where they receive little medical attention and live under precarious sanitary conditions. TB prevalence varies by ethnicity and geographic location and is generally higher in Amerindians than in non-indigenous (Creole) people.
  
  
  METHODS
  Between January 1, 1998 and December 31, 2009, the tuberculin skin test (TST) was administered during field operations to 9,538 Amerindian and Creole people between 0 and 94 years of age living in Venezuela. In 6,979 individuals (73%), Bacille Calmette-Guérin (BCG) vaccination status, age, and ethnicity were recorded. Univariate and multivariate analyses were performed to determine the influence of previous BCG vaccination, age, and ethnicity on TST outcomes.
  
  
  RESULTS
  Age, ethnicity, and the number of BCG vaccinations administered each had a significant influence on TST outcomes (p < 0.001). The influence of BCG vaccination on TST outcomes varied by ethnicity and was only significant in children aged between 0 and 3 years.
  
  
  CONCLUSIONS
  The utility of TST in the diagnosis of TB infection in high TB burden settings with widespread BCG vaccination should be evaluated locally and individually as this depends on ethnicity, age, and the number of BCG vaccinations administered. In Venezuelan children 4 years of age and older, the TST remains a useful tool for the detection of TB infection, independent of BCG vaccination status.
authors: Universidad Central de Venezuela, Caracas, Venezuela. mailismaes@gmail.com.
authors: Mailis
authors: M
authors: Maes
authors: Lilly M
authors: LM
authors: Verhagen
authors: Dagmarys
authors: D
authors: Ortega
authors: Gregorio L
authors: GL
authors: Sánchez
authors: Yajaira
authors: Y
authors: Segovia
authors: Berenice
authors: B
authors: del Nogal
authors: Jacobus H
authors: JH
authors: de Waard
mesh_terms: D000293:Adolescent; D001500:BCG Vaccine / Q000008:administration & dosage; D002648:Child; D002675:Child, Preschool; D004305:Dose-Response Relationship, Drug; D006801:Humans; D007223:Infant; D016014:Linear Models; D016015:Logistic Models; D015999:Multivariate Analysis; D009163:Mycobacterium bovis / Q000276:immunology; D015995:Prevalence; D012959:Socioeconomic Factors; D016896:Treatment Outcome; D014374:Tuberculin Test / Q000379:methods*; D014376:Tuberculosis / Q000175:diagnosis* / Q000208:ethnology*; D014611:Vaccination; D014687:Venezuela / Q000453:epidemiology
chemical_list: D001500:BCG Vaccine