Escobar A L, Coimbra C E A, Camacho L A B, Santos R V
Centro de Estudos em Saúde do Indio de Rondônia, Universidade Federal de Rondônia, Porto Velho, Brazil.
Int J Tuberc Lung Dis. 2004 Jan;8(1):45-51.
To investigate the characteristics of tuberculin skin test reactivity in the Pakaanóva Indians, in Amazonia, Brazil, after revaccination of all study participants with bacille Calmette-Guerin (BCG).
The investigation was designed as a post-BCG vaccination purified protein derivative (PPD) survey. Data included PPD readings, age, sex, nutritional status, place of residence, previous tuberculosis, physical examinations and BCG status. Bivariate and multivariate logistic regression analyses were conducted.
About 90% (n = 505) of the total population participated. One third (32.1%) of the subjects presented induration > or = 10 mm at 72 h. Induration sizes showed weak linear correlation with age; differences between sexes were not observed. Skin reaction was not associated with nutritional status. Individuals with a history of tuberculosis were six times more likely to test positive. History of tuberculosis, age, and previous BCG vaccination were significantly associated with PPD reactivity in the multivariate analyses.
The Pakaanóva showed a high proportion (58.4%) of non-reactors, even with a recent BCG booster. Sex differences in PPD reactivity were either not present or could not be demonstrated. The association between age and PPD reactivity resembles that observed in other Amazonian populations. The authors discuss the potential of PPD testing as a screening tool to enhance tuberculosis detection, especially in indigenous populations in Amazonia with limited access to health services.
在巴西亚马逊地区的帕卡诺瓦印第安人中，对所有研究参与者再次接种卡介苗（BCG）后，调查结核菌素皮肤试验反应性的特征。
该调查设计为卡介苗接种后纯化蛋白衍生物（PPD）调查。数据包括PPD读数、年龄、性别、营养状况、居住地点、既往结核病情况、体格检查和卡介苗接种状况。进行了双变量和多变量逻辑回归分析。
约90%（n = 505）的总人口参与了调查。三分之一（32.1%）的受试者在72小时时硬结≥10毫米。硬结大小与年龄呈弱线性相关；未观察到性别差异。皮肤反应与营养状况无关。有结核病病史的个体检测呈阳性的可能性高六倍。在多变量分析中，结核病病史、年龄和既往卡介苗接种与PPD反应性显著相关。
即使最近接种了卡介苗加强针，帕卡诺瓦人仍有高比例（58.4%）的无反应者。PPD反应性不存在性别差异或无法证明存在性别差异。年龄与PPD反应性之间的关联与在其他亚马逊人群中观察到的相似。作者讨论了PPD检测作为一种筛查工具在加强结核病检测方面的潜力，特别是在亚马逊地区获得医疗服务有限的土著人群中。
