有哪些信誉好的足球投注网站surprisingly high specificity of the ppd skin test for m. tuberculosis infection from recent exposure in the gambia惊人的高特异性ppd皮肤试验的结核分枝杆菌感染从最近曝光在冈比亚.pdfVIP
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surprisingly high specificity of the ppd skin test for m. tuberculosis infection from recent exposure in the gambia惊人的高特异性ppd皮肤试验的结核分枝杆菌感染从最近曝光在冈比亚
Surprisingly High Specificity of the PPD Skin Test for M. tuberculosis Infection from Recent Exposure in The Gambia Philip C. Hill*, Roger H. Brookes, Annette Fox, Dolly Jackson-Sillah, Moses D. Lugos, David J. Jeffries, Simon A. Donkor, Richard A. Adegbola, Keith P. W. J. McAdam Bacterial Diseases Programme, Medical Research Council Unit, Banjul, The Gambia Background. Options for intervention against Mycobacterium tuberculosis infection are limited by the diagnostic tools available. The Purified Protein Derivative (PPD) skin test is thought to be non-specific, especially in tropical settings. We compared the PPD skin test with an ELISPOT test in The Gambia. Methodology/Principal Findings. Household contacts over six months of age of sputum smear positive TB cases and community controls were recruited. They underwent a PPD skin test and an ELISPOT test for the T cell response to PPD and ESAT-6/CFP10 antigens. Responsiveness to M. tuberculosis exposure was analysed according to sleeping proximity to an index case using logistic regression. 615 household contacts and 105 community controls were recruited. All three tests assessed increased significantly in positivity with increasing M. tuberculosis exposure, the PPD skin test most dramatically (OR 15.7; 95% CI 6.6–35.3). While the PPD skin test positivity continued to trend downwards in the community with increasing distance from a known case (61.9% to 14.3%), the PPD and ESAT-6/CFP-10 ELISPOT positivity did not. The PPD skin test was more in agreement with ESAT-6/CFP-10 ELISPOT (75%, p = 0.01) than the PPD ELISPOT (53%, p,0.0001). With increasing M. tuberculosis exposure, the proportion of ESAT-6/CFP-10 positive contacts who were PPD skin test positive increased (p,0.0001), and the proportion of ESAT-6/CFP-10 negative contacts that were PPD skin test negative decreased (p,0.0001); the converse did not occur. Conc
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