{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T15:35:05Z","timestamp":1784907305599,"version":"3.55.0"},"reference-count":11,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2007,3,19]],"date-time":"2007-03-19T00:00:00Z","timestamp":1174262400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/www.springer.com\/tdm"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Public Health"],"published-print":{"date-parts":[[2007,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Background<\/jats:title>\n            <jats:p>Assuming a higher risk of latent tuberculosis (TB) infection in the population of Rio de Janeiro, Brazil, in October of 1998 the TB Control Program of Clementino Fraga Filho Hospital (CFFH) routinely started to recommend a two-step tuberculin skin test (TST) in contacts of pulmonary TB cases in order to distinguish a boosting reaction due to a recall of delayed hypersensitivity previously established by infection with <jats:italic>Mycobacterium tuberculosis (M.tb)<\/jats:italic> or BCG vaccination from a tuberculin conversion. The aim of this study was to assess the prevalence of boosted tuberculin skin tests among contacts of individuals with active pulmonary tuberculosis (TB).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>Retrospective cohort of TB contacts \u2265 12 years old who were evaluated between October 1<jats:sup>st<\/jats:sup>, 1998 and October 31<jats:sup>st<\/jats:sup> 2001. Contacts with an initial TST \u2264 4 mm were considered negative and had a second TST applied after 7\u201314 days. Boosting reaction was defined as a second TST \u2265 10 mm with an increase in induration \u2265 6 mm related to the first TST. All contacts with either a positive initial or repeat TST had a chest x-ray to rule out active TB disease, and initially positive contacts were offered isoniazid preventive therapy. Contacts that boosted did not receive treatment for latent TB infection and were followed for 24 months to monitor the development of TB. Statistical analysis of dichotomous variables was performed using Chi-square test. Differences were considered significant at a p &lt; 0.05.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>Fifty four percent (572\/1060) of contacts had an initial negative TST and 79% of them (455\/572) had a second TST. Boosting was identified in 6% (28\/455). The mean age of contacts with a boosting reaction was 42.3 \u00b1 21.1 and with no boosting was 28.7 \u00b1 21.7 (p = 0.01). Fifty percent (14\/28) of individuals whose test boosted met criteria for TST conversion on the second TST (increase in induration \u2265 10 mm). None of the 28 contacts whose reaction boosted developed TB disease within two years following the TST.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>The low number of contacts with boosting and the difficulty in distinguishing boosting from TST conversion in the second TST suggests that the strategy of two-step TST testing among contacts of active TB cases may not be useful. However, this conclusion must be taken with caution because of the small number of subjects followed.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1186\/1471-2458-7-38","type":"journal-article","created":{"date-parts":[[2007,5,2]],"date-time":"2007-05-02T15:32:41Z","timestamp":1178119961000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["The presence of a booster phenomenon among contacts of active pulmonary tuberculosis cases: a retrospective cohort"],"prefix":"10.1186","volume":"7","author":[{"given":"Cristiane G","family":"Salles","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Ruffino-Netto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jose R","family":"Lapa-e-Silva","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Afranio L","family":"Kritski","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle","family":"Cailleaux-Cesar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fernanda C","family":"Queiroz-Mello","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcus B","family":"Conde","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2007,3,19]]},"reference":[{"key":"649_CR1","doi-asserted-by":"publisher","first-page":"1860","DOI":"10.1056\/NEJMcp021045","volume":"347","author":"RM Jasmer","year":"2002","unstructured":"Jasmer RM, Nahid P, Hopewell PC: Latent tuberculosis infection. 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