A simple protocol for tuberculin skin test reading certification

dc.contributor.authorGloria, Lara de Lima
dc.contributor.authorBastos, Mayara Lisboa
dc.contributor.authorSantos Jr, Bráulio dos
dc.contributor.authorTrajman, Anete
dc.date.accessioned2024-03-07T14:10:55Z
dc.date.available2024-03-07T14:10:55Z
dc.date.issued2021
dc.description.abstractAlthough tuberculosis preventive therapy is one of the cornerstones for eliminating the disease, many barriers exist in the cascade of care for latent tuberculosis infection, including the need to certify healthcare professionals for reading tuberculin skin tests (TST). This paper proposes and evaluates a simple protocol for TST reading training. Primary care workers from different backgrounds received a 2-hour theoretical course, followed by a practical course on bleb reading. Blebs were obtained by injecting saline into sausages and then in volunteers. A certified trainer then evaluated the effectiveness of this protocol by analyzing the trainees' ability to read TST induration in clinical routine, blinded to each other's readings. Interobserver agreement was analyzed using the Bland-Altman test. The trainees' reading accuracy was calculated using two cut-off points - 5 and 10mm - and the effect of the number of readings was analyzed using a linear mixed model. Eleven healthcare workers read 53 saline blebs and 88 TST indurations, with high agreement for TST reading (0.07mm average bias). Sensitivity was 100% (94.6; 100.0) at 5mm cut-off and 87.3% (75.5; 94.7) at 10mm cut-off. The regression model found no effect of the number of readings [coefficient: -0.007 (-0.055; 0.040)]. A simple training protocol for reading TST with saline blebs simulations in sausages and volunteers was sufficient to achieve accurate TST induration readings, with no effect observed for the number of readings. Training with saline blebs injected into voluntary individuals is safer and easier than the traditional method.
dc.identifier.citationGloria LL, Bastos ML, Santos Júnior BD, Trajman A. A simple protocol for tuberculin skin test reading certification. Cad Saude Publica. 2021 Aug 30;37(8):e00027321. doi: 10.1590/0102-311X00027321.
dc.identifier.otherDOI: 10.1590/0102-311X00027321
dc.identifier.urihttps://dspace.inc.saude.gov.br/handle/123456789/423
dc.language.isoen
dc.publisherCadernos de Saúde Pública
dc.subject.meshTuberculin Testen
dc.subject.meshPrimary Health Careen
dc.subject.meshLatent Tuberculosisen
dc.subject.meshHumansen
dc.subject.meshCertificationen
dc.subject.meshBrazilen
dc.titleA simple protocol for tuberculin skin test reading certification
dc.typeArticle
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