Tuberculosis infection among cocaine crack users in Brazil

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dc.contributor.authorOliveira, Sandra Maria do Valle Leone de
dc.contributor.authorSilva, Elizeu Ferreira da
dc.contributor.authorMotta-Castro, Ana Rita Coimbra
dc.contributor.authorCastro, Vivianne de Oliveira Landgraf de
dc.contributor.authorStábile, Andréa Cristina
dc.contributor.authorPaniago, Anamaria Mello Miranda
dc.contributor.authorTrajman, Anete
dc.date.accessioned2024-12-13T20:19:35Z
dc.date.available2024-12-13T20:19:35Z
dc.date.issued2018
dc.description.abstractBackground: WHO recommends treatment for latent tuberculosis infection (LTBI) in the homeless and people who use drugs (PWUD). The optimal test for LTBI screening is uncertain. Methods: A cross-sectional study was conducted among the homeless and drug-rehabilitation clinic clients chronically using crack in Western Brazil. Participants were interviewed and offered HIV testing plus tuberculin skin testing (TST) and QuantiFeron®-Gold-in-Tube (QFT). We considered LTBI when either TST or QFT were positive. Factors associated with LTBI were adjusted in a multivariate model. Results: Among 372 subjects with at least one valid test, 216 (58%) had LTBI. TST was not read in 18.4%; QFT was indeterminate in 2.5%. TST detected 27 (26%) extra LTBI cases among 75 QFT-negative individuals. PWUD had over three-fold odds for LTBI. TST was 4.5 times more likely to be positive in BCG-vaccinated individuals. Conclusion: Given the high risk of progression to disease in this population, the high rates of loss to TST reading and the possibility of false-positive TST results from BCG vaccination, we endorse current CDC recommendations to use QFT for LTBI screening among the homeless and PWUD. However, because adding TST to a negative QFT increased LTBI detection considerably, TST should be considered in QFT-negative individuals.
dc.identifier.citationValle Leone de Oliveira SM, Ferreira da Silva E, Coimbra Motta-Castro AR, de Oliveira Landgraf de Castro V, Stábile AC, Mello Miranda Paniago A, Trajman A. Tuberculosis infection among cocaine crack users in Brazil. Int J Drug Policy. 2018 Sep;59:24-27. doi: 10.1016/j.drugpo.2018.06.012. Epub 2018 Jun 30.
dc.identifier.otherDOI: 10.1016/j.drugpo.2018.06.012
dc.identifier.urihttps://dspace.inc.saude.gov.br/handle/123456789/721
dc.language.isoen
dc.publisherInternational Journal of Drug Policy
dc.subjectCrack cocaineen
dc.subjectTuberculin testen
dc.subjectInterferon-gamma release assaysen
dc.subjectLatent tuberculosis infection.en
dc.titleTuberculosis infection among cocaine crack users in Brazil
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