The effect of deworming on tests of tuberculosis infection in children with recent tuberculosis exposure a randomized controlled trial
Pediatric Infectious Disease Journal, ISSN: 1532-0987, Vol: 35, Issue: 6, Page: 622-627
2016
- 16Citations
- 88Captures
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Metrics Details
- Citations16
- Citation Indexes13
- 13
- CrossRef10
- Policy Citations3
- Policy Citation3
- Captures88
- Readers88
- 85
Article Description
Background: Helminth infestations are associated with T-helper cell type 2 (Th2) immune responses, leading to suppression of Th1 responses required to control Mycobacterium tuberculosis infection. We hypothesized that deworming after documented M. tuberculosis exposure might improve Th1 immune responses. Methods: This was a randomized controlled trial comparing the effect of early versus delayed (after 3 months) deworming on tuberculin skin testing (TST) and Quantiferon-Gold-in-tube responses among children from a setting with a known high burden of M. tuberculosis and helminth co-infection in Cape Town, South Africa. Children aged 6 to 15 years with documented M. tuberculosis exposure were enrolled. Ascaris lumbricoides status was measured by Ascaris-specific IgE and stool microscopy. Results: A total of 250 children (mean age, 9.6 years) were enrolled; 11.9% (27/227) were Ascaris stool microscopy positive and 54.2% (135/249) were Ascaris stool and/or IgE positive (Ascaris status). In univariable analysis, deworming at enrollment was not associated with a negative TST at 3 months (odds ratio, 0.61; 95% confidence interval, 0.35-1.07; P = 0.08). In stratified analysis, children with a positive Ascaris status were more likely to be TST negative at 3 months if dewormed early (odds ratio, 0.49; 95% confidence interval, 0.23-1.04; P = 0.06). In multivariable analysis, deworming was not associated with TST status (adjusted odds ratios, 0.62; 95% confidence interval, 0.34-1.10; P = 0.10). There was no association between deworming and Quantiferon-Gold-in-tube status. Conclusions: Deworming in children with recent M. tuberculosis exposure is associated with a trend toward a negative TST result. Timing of deworming might influence interpretation of TST in settings with high burdens of tuberculosis and helminths.
Bibliographic Details
http://www.scopus.com/inward/record.url?partnerID=HzOxMe3b&scp=84959265234&origin=inward; http://dx.doi.org/10.1097/inf.0000000000001115; http://www.ncbi.nlm.nih.gov/pubmed/26933841; http://journals.lww.com/00006454-201606000-00006; http://Insights.ovid.com/crossref?an=00006454-201606000-00006; https://dx.doi.org/10.1097/inf.0000000000001115; https://journals.lww.com/pidj/Abstract/2016/06000/The_Effect_of_Deworming_on_Tests_of_Tuberculosis.6.aspx
Ovid Technologies (Wolters Kluwer Health)
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