Severe undernutrition in children affects tuberculin skin test performance in Southern India.

<h4>Background</h4>Undernutrition impairs immunity to Mycobacterium tuberculosis and is a risk factor for tuberculosis disease (TB). We aim to investigate if severe undernutrition affects the tuberculin skin test (TST) response among household contacts (HHCs) of pulmonary TB cases.<h4...

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Autores principales:	Divya Reddy, Yicheng Ma, Subitha Lakshminarayanan, Swaroop Sahu, Laura F White, Ayiraveetil Reshma, Gautam Roy, Padmini Salgame, Selby Knudsen, Chelsie Cintron, Jerrold J Ellner, C Robert Horsburgh, Sonali Sarkar, Natasha S Hochberg
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/72c1abbf616249a18221f4d6874ad4e3
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spelling	oai:doaj.org-article:72c1abbf616249a18221f4d6874ad4e32021-12-02T20:05:02ZSevere undernutrition in children affects tuberculin skin test performance in Southern India.1932-620310.1371/journal.pone.0250304https://doaj.org/article/72c1abbf616249a18221f4d6874ad4e32021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0250304https://doaj.org/toc/1932-6203<h4>Background</h4>Undernutrition impairs immunity to Mycobacterium tuberculosis and is a risk factor for tuberculosis disease (TB). We aim to investigate if severe undernutrition affects the tuberculin skin test (TST) response among household contacts (HHCs) of pulmonary TB cases.<h4>Methods</h4>We analyzed data from HHCs (> five years) of pulmonary TB cases in Southern India. Undernutrition was defined as per World Health Organization based on body mass index (BMI) for adults (undernutrition 16-18.4 and severe undernutrition <16 kg/m2) and BMI relative to the mean for children (undernutrition 2SD-3SD and severe undernutrition < 3SDs below mean). Univariate and multivariate models of TST positivity (> five mm) were calculated using logistic regression with generalized estimating equations.<h4>Results</h4>Among 1189 HHCs, 342 were children (age 5-17 years) and 847 were adults. Prevalence of TST positivity in well-nourished, undernourished and severely undernourished children was 135/251 (53.8%), 32/68 (47.1%), and 7/23 (30.4%) respectively; among adults, prevalence of TST positivity was 304/708 (42.9%), 43/112 (38.4%) and 12/26 (46.2%), respectively. Severe undernutrition in children was associated with decreased odds of TST positivity (adjusted odds ratio 0.3; 95%CI 0.1-0.9).<h4>Conclusion</h4>Severe undernutrition in children was associated with decreased odds of TST positivity. False-negative TSTs may result from undernutrition; caution is warranted when interpreting negative results in undernourished populations.Divya ReddyYicheng MaSubitha LakshminarayananSwaroop SahuLaura F WhiteAyiraveetil ReshmaGautam RoyPadmini SalgameSelby KnudsenChelsie CintronJerrold J EllnerC Robert HorsburghSonali SarkarNatasha S HochbergPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 7, p e0250304 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Divya Reddy Yicheng Ma Subitha Lakshminarayanan Swaroop Sahu Laura F White Ayiraveetil Reshma Gautam Roy Padmini Salgame Selby Knudsen Chelsie Cintron Jerrold J Ellner C Robert Horsburgh Sonali Sarkar Natasha S Hochberg Severe undernutrition in children affects tuberculin skin test performance in Southern India.
description	<h4>Background</h4>Undernutrition impairs immunity to Mycobacterium tuberculosis and is a risk factor for tuberculosis disease (TB). We aim to investigate if severe undernutrition affects the tuberculin skin test (TST) response among household contacts (HHCs) of pulmonary TB cases.<h4>Methods</h4>We analyzed data from HHCs (> five years) of pulmonary TB cases in Southern India. Undernutrition was defined as per World Health Organization based on body mass index (BMI) for adults (undernutrition 16-18.4 and severe undernutrition <16 kg/m2) and BMI relative to the mean for children (undernutrition 2SD-3SD and severe undernutrition < 3SDs below mean). Univariate and multivariate models of TST positivity (> five mm) were calculated using logistic regression with generalized estimating equations.<h4>Results</h4>Among 1189 HHCs, 342 were children (age 5-17 years) and 847 were adults. Prevalence of TST positivity in well-nourished, undernourished and severely undernourished children was 135/251 (53.8%), 32/68 (47.1%), and 7/23 (30.4%) respectively; among adults, prevalence of TST positivity was 304/708 (42.9%), 43/112 (38.4%) and 12/26 (46.2%), respectively. Severe undernutrition in children was associated with decreased odds of TST positivity (adjusted odds ratio 0.3; 95%CI 0.1-0.9).<h4>Conclusion</h4>Severe undernutrition in children was associated with decreased odds of TST positivity. False-negative TSTs may result from undernutrition; caution is warranted when interpreting negative results in undernourished populations.
format	article
author	Divya Reddy Yicheng Ma Subitha Lakshminarayanan Swaroop Sahu Laura F White Ayiraveetil Reshma Gautam Roy Padmini Salgame Selby Knudsen Chelsie Cintron Jerrold J Ellner C Robert Horsburgh Sonali Sarkar Natasha S Hochberg
author_facet	Divya Reddy Yicheng Ma Subitha Lakshminarayanan Swaroop Sahu Laura F White Ayiraveetil Reshma Gautam Roy Padmini Salgame Selby Knudsen Chelsie Cintron Jerrold J Ellner C Robert Horsburgh Sonali Sarkar Natasha S Hochberg
author_sort	Divya Reddy
title	Severe undernutrition in children affects tuberculin skin test performance in Southern India.
title_short	Severe undernutrition in children affects tuberculin skin test performance in Southern India.
title_full	Severe undernutrition in children affects tuberculin skin test performance in Southern India.
title_fullStr	Severe undernutrition in children affects tuberculin skin test performance in Southern India.
title_full_unstemmed	Severe undernutrition in children affects tuberculin skin test performance in Southern India.
title_sort	severe undernutrition in children affects tuberculin skin test performance in southern india.
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/72c1abbf616249a18221f4d6874ad4e3
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Severe undernutrition in children affects tuberculin skin test performance in Southern India.

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