Increased risk of tuberculosis in patients treated with antitumor necrosis factor alpha
Tuberculosis (Tbc) gained importance as a public health problem in the recent years. The course of the disease is more severe in childhood. Tbc screening was made by The Tuberculosis Control 11th Group Presidency on the primary school students in Cizre, in November 2005. A total of 2242 children have been taken to this study. Of the children, 1130 (50.4%) were boys and 1112 (49.6%) were girls. The mean age of the children was 6.9+/-0.8 (range, 4-14) years. Concerning Bacillus Calmette-Guerin (BCG) vaccine scar, 1676 (74.7%) children had no scar, 536 children (23.9%) had single scar, and 32 children (1.4%) had double scar. The mean diameter of the tuberculin skin test (TST) was 2.1+/-2.7 mm. Regarding sexuality and TST mean diameter, statistically significant relation was not detected between girls and boys (p=0.3). The mean diameter of TST were 1.5+/-1.4 mm, 3.5+/-4.0 mm and 11.2+/-3.3 mm in the children with no BCG scar, in those with single BCG scar, and in those with double BCG scar, respectively. Of the TST results of all children, 2065 (92.1%) were negative, 101 (4.5%) were attributed to BCG, and 76 (3.4%) were positive, respectively. The rate of positiveness of TST was 1.2% in the children with no BCG scar, 8.9% in the children with single BCG scar, and 50% in the children with double BCG scar, respectively. A statistically significant correlation between the increase in the BCG scar number and the increase in the TST mean diameter was detected (p<0.05). Of the children who were likely to have Tbc, 139 (6.2%) were advised to apply at the dispensary. Single BCG vaccination was inadequate in the children. We suggest encouraging the families about postpartal single BCG vaccination. Furthermore, school screenings should be paid greater attention.