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  1. Fulltext Tuberculosis contact tracing in low and middle income countries: a systematic review
    Norfazilah Ahmad, Siti Norbayah Yusof, Nurmawati Ahmad, Zaleha Md Nor, Juhaida Mohd Noor, Hasanain Faisal Ghazi, et al.
    Int J Public Health Res, 2018;8(1):924-932.
    MyJurnal
    Introduction Tuberculosis (TB) is a major global health challenge especially in low- and middle-income countries reflects improper, delayed or missed diagnosis. Contact screening should be utilized both as an efficient and effective targeted approach to intensify TB case finding.
    Methods Through a comprehensive systematic literature review of online database, this paper aims at providing an insight into the current practice of TB contact screening and to provide evidence based practice for formulation of appropriate policies in low- and middle-income countries. There are 24 articles included in this review from studies published from 2005 to 2014.
    Results Findings in literature varies substantially. Generally, contact screening is better intensified with clear operational guidelines, adequate training, include close contact outside household as appropriate and follow up at least for 1 year. Prioritizing high risk close contacts is helpful in resource limited setting. Tuberculin skin test is still of value as screening tool and intensified case finding must be accompanied with effective management protocol. Prophylaxis treatment is recommended especially for children especially less than 5 years old, unvaccinated, malnourished, living with person having HIV and close contact with MDR-TB.
    Conclusions Policy recommendations in improving TB management must incorporate complementary strategies to enhance case finding, effective management protocol for follow up or prophylaxis treatment, training for public health capacity and concerted dedication from various stakeholders
    Matched MeSH terms: Tuberculin Test
  2. Fulltext Influence of co-morbidity in the interpretation of tuberculin skin reactivity in multi-ethnic adult patients with tuberculosis
    Loh LC, Chan SK, Ch'ng KI, Tan LZ, Vijayasingham P, Thayaparan T
    Med J Malaysia, 2005 Oct;60(4):426-31.
    PMID: 16570703
    In the Malaysian setting of multi-ethnicity and high BCG coverage, interpretation of Tuberculin Skin Testing (TST) may be difficult. Between January 2001 and December 2003, a retrospective study on all adult patients with documented TST results treated for tuberculosis (TB) in chest clinics of two government hospitals was conducted to determine the reliability of TST and factors affecting its interpretation. One hundred and three patients [mean age (SD): 43 (17); male: 67%] were eligible for data collection: 72% and 57% of patients had positive TST results based on cut-off points of 10mm and 15mm respectively. The only significant univariate association with TST results was the severity of co-morbidity. A patient with co-morbidity score of 3 defined as those with any cancer, end-stage renal or liver disease, or HIV disease, was more likely to have a negative TST results [10mm cut-off point: Odd Ratio (95% CI) 6.6 (1.82 to 24.35), p = 0.003; 15mm cut-off point: 4.8 (1.21 to 18.95), p = 0.012]. A TST reading of 10mm had a higher sensitivity than 15mm as the cut-off point in diagnosing TB infection. Considering all possible confounding factors like ethnicity, prior BCG vaccination and TB burden in the population, severity of co-morbidity remains strongly predictive of a negative TST. Caution should be exercised in interpreting TST in these patients.
    Study site: Chest clinic, Hospital Seremban, Hospital Kuala Pilah, Negeri Sembilan, Malaysia
    Matched MeSH terms: Tuberculin Test*
  3. Testing Eurasian wild boar piglets for serum antibodies against Mycobacterium bovis
    Che' Amat A, González-Barrio D, Ortiz JA, Díez-Delgado I, Boadella M, Barasona JA, et al.
    Prev Vet Med, 2015 Sep 1;121(1-2):93-8.
    PMID: 26051843 DOI: 10.1016/j.prevetmed.2015.05.011
    Animal tuberculosis (TB) caused by infection with Mycobacterium bovis and closely related members of the M. tuberculosis complex (MTC), is often reported in the Eurasian wild boar (Sus scrofa). Tests detecting antibodies against MTC antigens are valuable tools for TB monitoring and control in suids. However, only limited knowledge exists on serology test performance in 2-6 month-old piglets. In this age-class, recent infections might cause lower antibody levels and lower test sensitivity. We examined 126 wild boar piglets from a TB-endemic site using 6 antibody detection tests in order to assess test performance. Bacterial culture (n=53) yielded a M. bovis infection prevalence of 33.9%, while serum antibody prevalence estimated by different tests ranged from 19% to 38%, reaching sensitivities between 15.4% and 46.2% for plate ELISAs and between 61.5% and 69.2% for rapid immunochromatographic tests based on dual path platform (DPP) technology. The Cohen kappa coefficient of agreement between DPP WTB (Wildlife TB) assay and culture results was moderate (0.45) and all other serological tests used had poor to fair agreements. This survey revealed the ability of several tests for detecting serum antibodies against the MTC antigens in 2-6 month-old naturally infected wild boar piglets. The best performance was demonstrated for DPP tests. The results confirmed our initial hypothesis of a lower sensitivity of serology for detecting M. bovis-infected piglets, as compared to older wild boar. Certain tests, notably the rapid animal-side tests, can contribute to TB control strategies by enabling the setup of test and cull schemes or improving pre-movement testing. However, sub-optimal test performance in piglets as compared to that in older wild boar should be taken into account.
    Matched MeSH terms: Tuberculin Test/veterinary*
  4. Fulltext Sweet-like syndrome in a patient with acute myeloid leukaemia
    Norhaya MR, Cheong SK, Hamidah NH, Ainoon O
    Singapore Med J, 1996 Jun;37(3):320-2.
    PMID: 8942241
    A 45-year-old Malay lady developed brisk vesicular, plaque-like reaction to a Mantoux test concomitant with a diagnosis of acute myeloid leukaemia (AML). The lesion resolved one month after chemotherapy. Similar lesions developed later after she was bitten by mosquitoes on the forearms. She also had the lesions over her cheek. A skin biopsy showed infiltration of the dermis with neutrophils and some monocytoid cells. The lesion resolved one week after prednisolone therapy.
    Matched MeSH terms: Tuberculin Test/adverse effects*
  5. Fulltext Latent tuberculosis infection screening in foreign-born populations: a successful mobile clinic outreach model
    Morano JP, Zelenev A, Walton MR, Bruce RD, Altice FL
    Am J Public Health, 2014 Aug;104(8):1508-15.
    PMID: 24922157 DOI: 10.2105/AJPH.2014.301897
    OBJECTIVES: We evaluated the efficacy of a mobile medical clinic (MMC) screening program for detecting latent tuberculosis infection (LTBI) and active tuberculosis.
    METHODS: A LTBI screening program in a MMC in New Haven, Connecticut, used medical surveys to examine risk factors and tuberculin skin test (TST) screening eligibility. We assessed clinically relevant correlates of total (prevalent; n = 4650) and newly diagnosed (incident; n = 4159) LTBI from 2003 to 2011.
    RESULTS: Among 8322 individuals, 4159 (55.6%) met TST screening eligibility criteria, of which 1325 (31.9%) had TST assessed. Similar to LTBI prevalence (16.8%; 779 of 4650), newly diagnosed LTBI (25.6%; 339 of 1325) was independently correlated with being foreign-born (adjusted odds ratio [AOR] = 8.49; 95% confidence interval [CI] = 5.54, 13.02), Hispanic (AOR = 3.12; 95% CI = 1.88, 5.20), Black (AOR = 2.16; 95% CI = 1.31, 3.55), employed (AOR = 1.61; 95% CI = 1.14, 2.28), and of increased age (AOR = 1.04; 95% CI = 1.02, 1.05). Unstable housing (AOR = 4.95; 95% CI = 3.43, 7.14) and marijuana use (AOR = 1.57; 95% CI = 1.05, 2.37) were significantly correlated with incident LTBI, and being male, heroin use, interpersonal violence, employment, not having health insurance, and not completing high school were significantly correlated with prevalent LTBI.
    CONCLUSIONS: Screening for TST in MMCs successfully identifies high-risk foreign-born, Hispanic, working, and uninsured populations and innovatively identifies LTBI in urban settings.
    Study site: Mobile clinic, New Haven, Connecticut, United States
    Matched MeSH terms: Tuberculin Test/methods
  6. Serial testing of Malaysian health care workers with QuantiFERON®-TB Gold In-Tube
    Rafiza S, Rampal KG
    Int J Tuberc Lung Dis, 2012 Feb;16(2):163-8.
    PMID: 22236915 DOI: 10.5588/ijtld.11.0364
    BACKGROUND: Serial testing for tuberculosis (TB) exposure has been advocated among health care workers (HCWs) at risk of nosocomial infection.
    OBJECTIVE: To determine the incidence and factors associated with TB infection among selected HCWs in Malaysia and to determine interferon-gamma response in serial testing.
    DESIGN: A cohort of 769 HCWs were retested after 1 year using QuantiFERON®-TB Gold In-Tube. Incidence of TB infection was determined among HCWs who previously tested negative. Conversion and reversion rates using several definitions were explored.
    RESULTS: Incidence of TB infection was 9.9 per 100 workers per year (95%CI 7.9-12.3). Working in the Emergency Department (ED; RR 2.18, 95%CI 1.07-4.43) was significantly associated with risk of TB infection. Reversion and conversion occurred frequently, with 46.7% reversion among HCWs with baseline interferon-gamma (IFN-γ) levels of 0.35-0.70 international units (IU)/ml, and 23.8% conversion among HCWs with baseline IFN-γ levels of 0.20-0.34 IU/ml.
    CONCLUSIONS: TB infection control measures need to be strengthened, particularly in the ED, as the incidence of TB was high. Conversion and reversion rates in serial testing were high, and further studies are needed to facilitate its interpretation.
    Matched MeSH terms: Tuberculin Test/instrumentation*
  7. Tuberculin skin testing among healthcare workers in the University of Malaya Medical Centre, Kuala Lumpur, Malaysia
    Tan LH, Kamarulzaman A, Liam CK, Lee TC
    Infect Control Hosp Epidemiol, 2002 Oct;23(10):584-90.
    PMID: 12400887
    To determine the occupational risk of Mycobacterium tuberculosis infection among healthcare workers (HCWs) and to examine the utility of tuberculin skin testing in a developing country with a high prevalence of bacille Calmette-Guerin vaccination.
    Matched MeSH terms: Tuberculin Test/utilization*
  8. Fulltext Ocular Tuberculosis Initially Presenting as Central Retinal Vein Occlusion
    Mahyudin M, Choo MM, Ramli NM, Omar SS
    Case Rep Ophthalmol, 2010 Aug 02;1(1):30-35.
    PMID: 21116342
    A 23-year-old man presented with central retinal vein occlusion. The retinal haemorrhages worsened and signs of retinal vasculitis appeared later as vision dropped from 6/60 to Counting Fingers. No signs of systemic disease were observed. Routine Mantoux test and chest radiograph were negative for tuberculosis. Fundus flourescein angiogram confirmed presence of retinal vasculitis. Both systemic and topical corticosteroid therapy were ineffective. Polymerase chain reaction analysis of vitreous fluid showed presence of Mycobacterium tuberculosis. A full 6-month course of antituberculosis therapy was given and inflammation subsided. Vision improved to 3/60. This is a rare case of ocular tuberculosis without evidence of systemic infection, presenting first as a central retinal vein occlusion.
    Matched MeSH terms: Tuberculin Test
  9. Fulltext Cell-mediated immunity in nasopharyngeal carcinoma and allergic rhinitis: a controlled study
    Wong HT, Shahrizal TA, Prepageran N, Lim WK, Raman R
    Ear Nose Throat J, 2007 May;86(5):292-4.
    PMID: 17580811
    We conducted a prospective study of 60 patients in a tertiary care referral center to ascertain the status of cell-mediated immunity as determined by delayed hypersensitivity reactions in patients with nasopharyngeal carcinoma (NPC) or allergic rhinitis. Delayed hypersensitivity as detected by Mantoux testing is generally accepted as a reflection of the level of cell-mediated immunoactivity-the less hypersensitivity reaction that occurs, the lower the level of immunoactivity is, and vice versa. Our study population was made up of three groups: 20 newly diagnosed patients with NPC (pretreatment), 20 age- and sex-matched patients with allergic rhinitis, and 20 matched controls without either disease. A negative Mantoux test (0- to 5-mm induration) was seen in 13 patients with NPC (65.0%), in 17 patients with allergic rhinitis (85.0%), and in 16 controls (80.0%); none of these differences was statistically significant. However, it is interesting that while the NPC group had the lowest percentage of negative Mantoux results overall, it had the highest percentage of patients who had no reaction at all (i.e., 0-mm induration); a complete absence of any reaction was seen in 7 of the 13 Mantoux-negative NPC patients (53.8%), compared with 2 of the 17 Mantoux-negative allergic rhinitis patients (11.8%) and 3 of the 16 Mantoux-negative controls (18.8%). An absence of a reaction generally indicates a very limited degree of cell-mediated immunoactivity. Therefore, we conclude that patients with NPC appear to have significantly less cell-mediated immunity than do patients with allergic rhinitis and normal controls; no statistically significant difference was noted between the latter two groups.
    Study site: ENT clinic, University Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia
    Matched MeSH terms: Tuberculin Test
  10. Fulltext Epidemiology of latent tuberculosis infection among patients with and without diabetes mellitus
    Swarna Nantha Y, Puri A, Mohamad Ali SZ, Suppiah P, Che Ali SA, Ramasamy B, et al.
    Fam Pract, 2017 09 01;34(5):532-538.
    PMID: 28369346 DOI: 10.1093/fampra/cmx017
    Background: Individuals with type 2 diabetes mellitus (DM) are at a greater risk of tuberculosis (TB) reactivation. There is a paucity of information about the risk factors associated with latent tuberculosis infection (LTBI) in patients with diabetes.

    Objective: We conducted an observational study to compare the prevalence and risk factors associated with LTBI factors in Malaysian adults with and without DM.

    Methods: Four hundred and four patients with DM and 359 patients with non-DM at a regional primary care clinic were recruited as participants in this case-control study. The tuberculin sensitivity test (TST) was performed. The presence of LTBI was defined by a TST value of 10 mm in DM patients and 10 mm in the non-DM group. A logistic regression model was used to identify variables associated with LTBI.

    Results: There was no statistical significant difference in the prevalence rates seen between the DM and non-DM group of the study. LTBI prevalence among patients with DM was 28.5%. The proportion of patients in the non-DM group with LTBI was 29.2%. When a critical cut-off of 8 mm was used, the adjusted odds ratio of LTBI in DM patients was 1.88 (95% confidence interval: 1.22-2.82). Smoking was an independent risk factor for LTBI regardless of DM status. HbA1c levels or anthropometric measurements were not associated with LTBI in diabetic patients.

    Conclusions: There is no significant risk of contracting LTBI in DM patients using the standard 10-mm TST cut-off. Nonetheless, using lower cut-offs in a DM population appear valid. Smoking is an important predictor of LTBI.
    Matched MeSH terms: Tuberculin Test
  11. Fulltext The Kveim test in lepromatous and tuberculoid leprosy
    Pearson JMH, Pettit JHS, Siltzbach LE, Ridley DS, Hart PD, Rees RJ
    Int. J. Lepr. Other Mycobact. Dis., 1969;37(4):372-81.
    PMID: 5394258
    Kveim tests using a validated material have been undertaken in Malaysia on 39 patients (32 Chinese; 4 Malay and 3 Aboriginal) with lepromatous or tuberculoid leprosy. All the patients had been treated for leprosy, most for two or more years. The tests were read microscopically. Of the 21 lepromatous patients one gave a weak positive and two an equivocal Kveim test whereas four of the nine tuberculoid patients gave equivocal or weak Kveim positivity. Only the tuberculoid form elicits a higher proportion of granulomas than might be expected in a comparable normal population. Of nine patients (8 lepromatous; 1 tuberculoid ) who failed to sensitize well to tuberculin
    following two BCG vaccinations, two gave equivocal Kveim tests similar in appearance to those in the other groups.
    Matched MeSH terms: Tuberculin Test
  12. Ocular tuberculosis in Hospital Universiti Sains Malaysia - A case series
    Shahidatul-Adha M, Zunaina E, Liza-Sharmini AT, Wan-Hazabbah WH, Shatriah I, Mohtar I, et al.
    Ann Med Surg (Lond), 2017 Dec;24:25-30.
    PMID: 29062482 DOI: 10.1016/j.amsu.2017.10.003
    INTRODUCTION: Ocular tuberculosis (TB) encompasses a broad spectrum of clinical manifestations affecting different structures of the eye. It is caused by Mycobacterium tuberculosis, a great ancient organism that induces various types of diseases and unfavorable outcomes if unrecognized and not well treated.

    PURPOSE: To report the clinical profile of 34 ocular TB cases observed during 6 years period in Hospital Universiti Sains Malaysia (HUSM).

    METHOD: A retrospective review of medical records from 34 patients diagnosed with ocular TB in HUSM from January 2011 until December 2016.

    RESULTS: The mean age was 43 ± 14.6 years old. Both male and female affected in about 1:1 ratio. The majority of subjects were local Malays (91.2%). Risk factors included previous contact with pulmonary TB patients (38.2%), and patients with underlying diabetes mellitus (26.5%). Most patients showed normal chest radiography (79.4%). However they had positive Mantoux test (94.1%) and raised erythrocyte sedimentation rate (ESR) value (58.8%). Uveitis was the most common ocular manifestation of ocular TB (70.6%) while the rare ocular manifestations included optic perineuritis and optic neuritis, orbital apex syndrome, orbital cellulitis, sclerokeratitis, corneal ulcer and conjunctival abscess. All patients responded well to anti-TB treatment, but visual outcome was variable.

    CONCLUSIONS: This review shows the diverse entity of ocular TB spectrum in an endemic area. Good clinical response to anti-tuberculous therapy supported the presumed diagnosis of ocular TB in majority of the cases.

    Matched MeSH terms: Tuberculin Test
  13. Sensitivity to tuberculin, PPD-B and histoplasmin in the population of Sabah in East Malaysia
    Roy RN
    Med J Aust, 1971 Feb 06;1(6):317-21.
    PMID: 5546216
    Matched MeSH terms: Tuberculin Test
  14. Fulltext Prevalence and Factors Associated with Tuberculosis Treatment Success among TB/HIV Co-Infection in North-East Malaysia
    Jalal TMT, Abdullah S, Wahab FA, Dir S, Naing NN
    Malays J Med Sci, 2017 Dec;24(6):75-82.
    PMID: 29379389 DOI: 10.21315/mjms2017.24.6.9
    Background: One of the six strategies developed by WHO, in order to stop Tuberculosis (TB) is addressing TB/HIV high-risk groups. This study aimed to determine the prevalence of successful TB treatment and factors associated with TB treatment success among TB/HIV co-infection patients in North-East Malaysia.
    Methods: A cross-sectional study was carried out in the a-year period from 2003 to 2012 by reviewing TB/HIV records in all hospitals and health clinics. The outcome of interest was treatment success as defined by Ministry of Health (MOH) when the patients was cured or completed TB treatment.
    Results: Out of 1510 total TB/HIV co-infection cases, 27.9% (95% CI: 25.2, 30.6) of the patients were having treatment success. A majority of TB/HIV co-infection cases were male (91.1%). Fifty-eight percent the patients were drug addicts and 6% were having positive tuberculin tests. The multiple logistic regression revealed that male (OR: 0.39, 95% CI: 0.22, 0.71) and positive tuberculin test result (OR: 2.61, 95% CI: 1.63, 4.19) were significantly associated with the treatment success of TB/HIV co-infection patients. Other factors such as age, comorbid, sputum smear and x-ray findings were not significantly factors in this study.
    Conclusion: Female patients and those with negative tuberculin test should be emphasised for successful tuberculosis treatment.
    Matched MeSH terms: Tuberculin Test
  15. Fulltext Latent tuberculosis infection in a Malaysian prison: implications for a comprehensive integrated control program in prisons
    Al-Darraji HA, Kamarulzaman A, Altice FL
    BMC Public Health, 2014 Jan 10;14:22.
    PMID: 24405607 DOI: 10.1186/1471-2458-14-22
    Prisons continue to fuel tuberculosis (TB) epidemics particularly in settings where access to TB screening and prevention services is limited. Malaysia is a middle-income country with a relatively high incarceration rate of 138 per 100,000 population. Despite national TB incidence rate remaining unchanged over the past ten years, data about TB in prisons and its contribution to the overall national rates does not exist. This survey was conducted to address the prevalence of latent TB infection (LTBI) in Malaysia's largest prison.
    Matched MeSH terms: Tuberculin Test
  16. Fulltext Prevalence of tuberculosis symptoms and latent tuberculous infection among prisoners in northeastern Malaysia
    Margolis B, Al-Darraji HA, Wickersham JA, Kamarulzaman A, Altice FL
    Int J Tuberc Lung Dis, 2013 Dec;17(12):1538-44.
    PMID: 24200265 DOI: 10.5588/ijtld.13.0193
    There are currently no routine screening procedures for active tuberculosis (TB) or latent tuberculous infection (LTBI) in Malaysian prisons.
    Matched MeSH terms: Tuberculin Test
  17. Tuberculosis in Muruts of Pensiangan in Sabah
    Roy RN
    Med J Aust, 1969 Apr 26;1(17):842-8.
    PMID: 4977736
    Matched MeSH terms: Tuberculin Test
  18. Pulmonary tuberculosis in a rural area of Sarawak, Malaysia
    Yano K, Goto S, Sado M, Takeuchi M, Iguchi M
    Southeast Asian J Trop Med Public Health, 1974 Sep;5(3):417-23.
    PMID: 4215145
    Matched MeSH terms: Tuberculin Test
  19. Fulltext Prevalence and risk factors of latent tuberculosis infection among health care workers in Malaysia
    Rafiza S, Rampal KG, Tahir A
    BMC Infect Dis, 2011;11:19.
    PMID: 21244645 DOI: 10.1186/1471-2334-11-19
    BACKGROUND: Health care workers are exposed to patients with tuberculosis and are at risk of nosocomial infection. The aim of this study was to determine the prevalence and factors associated with latent tuberculosis infection among health care workers in Malaysia and also to evaluate the agreement between Quantiferon TB Gold in tube test with Tuberculin Skin Test.
    METHODS: A cross sectional study was conducted at four randomly selected hospitals in the Klang Valley from December 2008 to May 2009. Self administered questionnaire was used to obtain information on health care workers and possible risk factors. The response rate for this study was 90.8% with 954 respondents completed the questionnaire and were tested with Quantiferon TB Gold in tube for latent tuberculosis infection. Agreement between Quantiferon TB Gold in tube and Tuberculin Skin Test was assessed among 95 health care workers who consented to undergo both tests.
    RESULTS: The overall prevalence of latent tuberculosis infection among health care workers was 10.6% (CI: 8.6%; 12.6%). Factors significantly associated with latent tuberculosis infection were aged 35 years and older [9.49 (CI: 2.22; 40.50)], history of living in the same house with close family members or friends who had active tuberculosis [8.69 (CI: 3.00; 25.18)], worked as a nurse [4.65 (CI: 1.10; 19.65)] and being male [3.70 (CI: 1.36; 10.02)]. Agreement between Quantiferon TB Gold in tube test and tuberculin skin test at cut-off points of 10 mm and 15 mm was 50.5% and 82.1% respectively. However, Kappa-agreement was poor for both cut-off points.
    CONCLUSION: The prevalence of latent tuberculosis infection in Malaysia was relatively low for an intermediate TB burden country. We could not comment on the occupational risk of latent tuberculosis infection among health care worker compared to the general population as there were no prevalence data available for latent tuberculosis infection in the general population. Kappa agreement between Quantiferon TB gold in-tube and tuberculin skin test was poor.
    Matched MeSH terms: Tuberculin Test
  20. Tuberculosis screening in a novel substance abuse treatment center in Malaysia: implications for a comprehensive approach for integrated care
    Al-Darraji HA, Wong KC, Yeow DG, Fu JJ, Loeliger K, Paiji C, et al.
    J Subst Abuse Treat, 2014 Feb;46(2):144-9.
    PMID: 24074846 DOI: 10.1016/j.jsat.2013.08.023
    People who use drugs (PWUD) represent a key high risk group for tuberculosis (TB). The prevalence of both latent TB infection (LTBI) and active disease in drug treatment centers in Malaysia is unknown. A cross-sectional convenience survey was conducted to assess the prevalence and correlates of LTBI among attendees at a recently created voluntary drug treatment center using a standardized questionnaire and tuberculin skin testing (TST). Participants (N=196) were mostly men (95%), under 40 (median age=36 years) and reported heroin use immediately before treatment entry (75%). Positive TST prevalence was 86.7%. Nine (4.6%) participants were HIV-infected. Previous arrest/incarcerations (AOR=1.1 for every entry, p<0.05) and not being HIV-infected (AOR=6.04, p=0.03) were significantly associated with TST positivity. There is an urgent need to establish TB screening and treatment programs in substance abuse treatment centers and to tailor service delivery to the complex treatment needs of patients with multiple medical and psychiatric co-morbidities.
    Matched MeSH terms: Tuberculin Test
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