Influence of Bacille Calmette-Guérin on tuberculin skin testing in Venezuelan Amerindians in high tuberculosis burden areas

  • Mailis Maes Universidad Central de Venezuela, Caracas, Venezuela
  • Lilly M Verhagen Universidad Central de Venezuela, Caracas, Venezuela
  • Dagmarys Ortega Servicio Autónomo Centro Amazónico de Investigación y Control de Enfermedades Tropicales, Estado Amazonas, Puerto Ayacucho, Venezuela
  • Gregorio L Sánchez Servicio Autónomo Centro Amazónico de Investigación y Control de Enfermedades Tropicales, Estado Amazonas, Puerto Ayacucho, Venezuela
  • Yajaira Segovia Ministerio de Salud, Estado Delta Amacuro, Tucupita, Venezuela
  • Berenice del Nogal Universidad Central de Venezuela, Caracas, Venezuela
  • Jacobus H de Waard Universidad Central de Venezuela, Caracas, Venezuela
Keywords: tuberculin skin test, BCG vaccination, Amerindians

Abstract

Introduction:E xtraordinarily 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.

Methodology: 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.

Author Biographies

Mailis Maes, Universidad Central de Venezuela, Caracas, Venezuela
Laboratorio de Tuberculosis
Lilly M Verhagen, Universidad Central de Venezuela, Caracas, Venezuela
Laboratorio de Tuberculosis, Laboratory of Pediatric Infectious Diseases
Yajaira Segovia, Ministerio de Salud, Estado Delta Amacuro, Tucupita, Venezuela
Comisión de Salud  del Municipio Antonio Diaz
Berenice del Nogal, Universidad Central de Venezuela, Caracas, Venezuela
Facultad de Medicina José María Vargas, Departamento de Pediatría
Jacobus H de Waard, Universidad Central de Venezuela, Caracas, Venezuela
Laboratorio de Tuberculosis, Facultad de Medicina José María Vargas
Published
2014-02-13
How to Cite
1.
Maes M, Verhagen LM, Ortega D, Sánchez GL, Segovia Y, del Nogal B, de Waard JH (2014) Influence of Bacille Calmette-Guérin on tuberculin skin testing in Venezuelan Amerindians in high tuberculosis burden areas. J Infect Dev Ctries 8:176-183. doi: 10.3855/jidc.3297
Section
Original Articles