Self-assessment of tuberculin skin test reactions by drug users with or at risk for human immunodeficiency virus infection

Marc N. Gourevitch, R. Teeter, Ellie Schoenbaum, R. S. Klein

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

SETTING: Self-assessment of tuberculin test results, if accurate, could enhance tuberculosis screening efforts by reducing the need for follow-up visits for skin test reading. We investigated tuberculin test self-assessment in a longitudinal study of tuberculosis infection among drug users. OBJECTIVE: To determine the accuracy of tuberculin reaction self-assessment by drug users at high risk for tuberculosis infection. DESIGN: Two readings were compared of the same skin test, performed 48-72 hours after placement: 1) self-assessment using a simple yes-no approach to induration, versus 2) trained examiner reading. Self-assessments were performed immediately prior to trained examiner readings. RESULTS: Participants were 137 human immunodeficiency virus (HIV) seropositive and 344 HIV-seronegative current and former drug users. Ten per cent (35/344) of reactions read by participants as 'flat' were read by trained examiners as ≥5 mm (54% of which were ≥10 mm). Twenty-three per cent (19/82) of reactions read by trained examiners as ≥10 mm and 32% (35/110) of reactions read by trained examiners as being ≥5 mm were self-read by participants as 'flat'. Sensitivity (0.68) and specificity (0.83) of self-read tuberculin reactions were sub-optimal. Inter-reader reliability was poorer between participants and trained examiners than between trained examiners. CONCLUSION: Self-assessments of tuberculin skin test responses by drug users with or at risk for HIV infection are not reliable.

Original languageEnglish (US)
Pages (from-to)321-325
Number of pages5
JournalInternational Journal of Tuberculosis and Lung Disease
Volume3
Issue number4
StatePublished - 1999

Fingerprint

Tuberculin Test
Virus Diseases
Drug Users
Skin Tests
HIV
Reading
Tuberculosis
Tuberculin
Infection
Longitudinal Studies
Self-Assessment
Sensitivity and Specificity

Keywords

  • Drug users
  • HIV
  • PPD
  • Self-assessment
  • Tuberculin

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

Cite this

Self-assessment of tuberculin skin test reactions by drug users with or at risk for human immunodeficiency virus infection. / Gourevitch, Marc N.; Teeter, R.; Schoenbaum, Ellie; Klein, R. S.

In: International Journal of Tuberculosis and Lung Disease, Vol. 3, No. 4, 1999, p. 321-325.

Research output: Contribution to journalArticle

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