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Impact of negative tuberculin skin test on growth among disadvantaged Bangladeshi children


Autoři: S. M. Abdul Gaffar aff001;  Mohammod Jobayer Chisti aff001;  Mustafa Mahfuz aff001;  Tahmeed Ahmed aff001
Působiště autorů: Nutrition and Clinical Services Division (NCSD), International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh aff001
Vyšlo v časopise: PLoS ONE 14(11)
Kategorie: Research Article
doi: https://doi.org/10.1371/journal.pone.0224752

Souhrn

Millions of children are suffering from tuberculosis (TB) worldwide and often end-up with fatal outcome especially in resource-poor settings. Tuberculin skin test (TST) is a conventionally used diagnostic test, less sensitive but highly specific for the diagnosis of clinical TB especially in undernourished children. However, we do not have any data on the role of TST positivity among the children who received nutritional intervention. Our aim was to examine the growth differences between TST-positive and TST-negative undernourished children aged 12 to 18 months who received nutritional intervention prospectively for 90 feeding days. Our further aim was to explore the determinants of TST positivity at enrollment. TB screening as one of the secondary causes of malnutrition was performed on 243 stunted [length for age Z score (LAZ) <-2 standard deviations] or at-risk of stunting (LAZ score between <-1 and -2 standard deviations) children in a community-based intervention study designed to improve their growth parameters. Differences of growth between TST-positives (n = 29) and TST-negatives (n = 214) were compared using paired samples t-test and multivariable linear regression from anthropometric data collected before and after nutritional intervention. Multivariable logistic regression was used to find out possible predictors of TST positivity using baseline sociodemographic data. Of the 243 children screened, 29 (11.9%) were TST-positive and 11 (4.5%) had clinically diagnosed pulmonary TB. Statistically significant improvement of LAZ and weight for age Z-score (WAZ) were observed among the TST-negative participants at the end of intervention period (p = 0.03 for LAZ and p = 0.01 for WAZ). However, we did not find any association between TST status and response to nutritional intervention in our multivariable linear regression models. Our study findings demonstrated a positive impact of nutritional intervention on growth parameters among TST-negative participants.

Klíčová slova:

Children – Malnutrition – Skin tests – Tuberculosis – Tuberculosis diagnosis and management – Tuberculin


Zdroje

1. Dodd PJ, Yuen CM, Sismanidis C, Seddon JA, Jenkins HE. The global burden of tuberculosis mortality in children: a mathematical modelling study. The Lancet Global health. 2017;5(9):e898–e906. Epub 2017/08/16. doi: 10.1016/S2214-109X(17)30289-9 28807188.

2. Dodd PJ, Gardiner E, Coghlan R, Seddon JA. Burden of childhood tuberculosis in 22 high-burden countries: a mathematical modelling study. The Lancet Global health. 2014;2(8):e453–9. Epub 2014/08/12. doi: 10.1016/S2214-109X(14)70245-1 25103518.

3. World Health Organization (WHO). Global tuberculosis report 2018. Geneva, Switzerland: 2018.

4. Black RE, Victora CG, Walker SP, Bhutta ZA, Christian P, de Onis M, et al. Maternal and child undernutrition and overweight in low-income and middle-income countries. The Lancet. 2013;382(9890):427–51.

5. Bryce J, Coitinho D, Darnton-Hill I, Pelletier D, Pinstrup-Andersen P. Maternal and child undernutrition: Effective action at national level. The Lancet. 2008;371(9611):510–26.

6. Hossain S, Zaman K, Banu S, Quaiyum MA, Husain MA, Islam MA, et al. Tuberculin survey in Bangladesh, 2007–2009: prevalence of tuberculous infection and implications for TB control. The international journal of tuberculosis and lung disease: the official journal of the International Union against Tuberculosis and Lung Disease. 2013;17(10):1267–72. Epub 2013/09/13. doi: 10.5588/ijtld.13.0114 24025376.

7. Cegielski JP, McMurray DN. The relationship between malnutrition and tuberculosis: evidence from studies in humans and experimental animals. The international journal of tuberculosis and lung disease: the official journal of the International Union against Tuberculosis and Lung Disease. 2004;8(3):286–98. Epub 2004/05/14. 15139466.

8. Ahmed T, Mahfuz M, Islam MM, Mondal D, Hossain MI, Ahmed AS, et al. The MAL-ED Cohort Study in Mirpur, Bangladesh. Clinical infectious diseases: an official publication of the Infectious Diseases Society of America. 2014;59(Suppl 4):S280–6. Epub 2014/10/12. doi: 10.1093/cid/ciu458 25305298.

9. Mahfuz M, Das S, Mazumder RN, Masudur Rahman M, Haque R, Bhuiyan MMR, et al. Bangladesh Environmental Enteric Dysfunction (BEED) study: protocol for a community-based intervention study to validate non-invasive biomarkers of environmental enteric dysfunction. BMJ open. 2017;7(8):e017768. Epub 2017/08/13. doi: 10.1136/bmjopen-2017-017768 28801442.

10. National Tuberculosis Control Programme (NTP) Bangladesh, World Health Organization (WHO). National guidelines for the management of tuberculosis in children. Dhaka, Bangladesh: 2016.

11. World Health Organization (WHO). Guidance for national tuberculosis programmes on the management of tuberculosis in children. Geneva, Switzerland: 2014.

12. Chisti MJ, Salam MA, Shahid ASMSB, Shahunja KM, Das SK, Faruque ASG, et al. Diagnosis of Tuberculosis Following World Health Organization-Recommended Criteria in Severely Malnourished Children Presenting With Pneumonia. Glob Pediatr Health. 2017;4:2333794X16686871–2333794X. doi: 10.1177/2333794X16686871 28229100.

13. Hill PC, Brookes RH, Fox A, Jackson-Sillah D, Lugos MD, Jeffries DJ, et al. Surprisingly high specificity of the PPD skin test for M. tuberculosis infection from recent exposure in The Gambia. PloS one. 2006;1(1):e68–e. doi: 10.1371/journal.pone.0000068 17183699.

14. Rose DN, Schechter CB, Adler JJ. Interpretation of the tuberculin skin test. Journal of General Internal Medicine. 1995;10(11):635–42. doi: 10.1007/bf02602749 8583267

15. Martin SJ, Sabina EP. Malnutrition and Associated Disorders in Tuberculosis and Its Therapy. Journal of dietary supplements. 2018:1–9. Epub 2018/06/30. doi: 10.1080/19390211.2018.1472165 29958051.

16. Oshikoya KA, Senbanjo IO. Caution when treating tuberculosis in malnourished children. Arch Dis Child. 2018. Epub 2018/08/23. doi: 10.1136/archdischild-2018-314972 30131349.

17. Martinez L, Shen Y, Mupere E, Kizza A, Hill PC, Whalen CC. Transmission of Mycobacterium Tuberculosis in Households and the Community: A Systematic Review and Meta-Analysis. American journal of epidemiology. 2017;185(12):1327–39. Epub 2017/10/07. doi: 10.1093/aje/kwx025 28982226.

18. Martinez L, le Roux DM, Barnett W, Stadler A, Nicol MP, Zar HJ. Tuberculin skin test conversion and primary progressive tuberculosis disease in the first 5 years of life: a birth cohort study from Cape Town, South Africa. The Lancet Child & adolescent health. 2018;2(1):46–55. Epub 2018/02/20. doi: 10.1016/s2352-4642(17)30149-9 29457055.

19. Gustafson P, Lisse I, Gomes V, Vieira CS, Lienhardt C, Naucler A, et al. Risk factors for positive tuberculin skin test in Guinea-Bissau. Epidemiology (Cambridge, Mass). 2007;18(3):340–7. Epub 2007/04/17. doi: 10.1097/01.ede.0000259987.46912.2b 17435442.

20. Hoa NB, Cobelens FG, Sy DN, Nhung NV, Borgdorff MW, Tiemersma EW. First national tuberculin survey in Viet Nam: characteristics and association with tuberculosis prevalence. The international journal of tuberculosis and lung disease: the official journal of the International Union against Tuberculosis and Lung Disease. 2013;17(6):738–44. Epub 2013/05/17. doi: 10.5588/ijtld.12.0200 23676155.

21. Black RE, Brown KH, Becker S. Effects of diarrhea associated with specific enteropathogens on the growth of children in rural Bangladesh. Pediatrics. 1984;73(6):799–805. Epub 1984/06/01. 6374599.

22. Martorell R, Habicht JP, Yarbrough C, Lechtig A, Klein RE, Western KA. Acute morbidity and physical growth in rural Guatemalan children. American journal of diseases of children (1960). 1975;129(11):1296–301. Epub 1975/11/01. doi: 10.1001/archpedi.1975.02120480022007 1190161.

23. Hlaing T. Ascariasis and childhood malnutrition. Parasitology. 1993;107 Suppl:S125–36. Epub 1993/01/01. doi: 10.1017/s0031182000075557 8115177.

24. MAL-ED Network Investigators. Relationship between growth and illness, enteropathogens and dietary intakes in the first 2 years of life: findings from the MAL-ED birth cohort study. BMJ global health. 2017;2(4):e000370. Epub 2018/01/16. doi: 10.1136/bmjgh-2017-000370 29333282.

25. Platts-Mills JA, Taniuchi M, Uddin MJ, Sobuz SU, Mahfuz M, Gaffar SA, et al. Association between enteropathogens and malnutrition in children aged 6–23 mo in Bangladesh: a case-control study. Am J Clin Nutr. 2017;105(5):1132–8. Epub 2017/04/07. doi: 10.3945/ajcn.116.138800 28381477.


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