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Frequency of Latent TB Infection in Patients with Spondyloarthritis in a Tertiary Care Hospital in Bangladesh
American Journal of Biomedical and Life Sciences
Volume 8, Issue 6, December 2020, Pages: 202-205
Received: Oct. 17, 2020; Accepted: Nov. 2, 2020; Published: Nov. 9, 2020
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Abu Tahir Muhammad Tanveer Hasan, Department of Rheumatology, Enam Medical College & Hospital, Dhaka, Bangladesh
Muhammad Abdul Alim, Centre for Rheumatic Care & Research, Green Life Hospital, Dhaka, Bangladesh
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Background & Objective: Screening for latent TB infection is recommended prior to the initiation of the newer and more effective treatment modalities of spondyloathritis such as biologic agents and tofacitinib. The prevalence of latent TB infection in the adult population of Bangladesh is not yet known. The figure is 40% in the general population in India that is demographically similar to the Bangladeshi population. The objective of this study was to assess the frequency of latent TB infection in patients with spondyloarhtritis visiting a tertiary hospital. Materials & Methods: This study was conducted in the Department of Rheumatology of Enam Medical College & Hospital, Savar, Dhaka, Bangladesh from October 2018 to December 2019. Each of the 75 participants underwent Mantoux test as a screening procedure for the detection of latent TB infection. Results: Mantoux test was positive (≥10 mm) in 10.3% of the participants. A reading between 5 and 9 mm was found in 33.7% of the participants and the rest of the participants (56%) had induration diameters <5 mm). 44% of the participants had readings ≥5 mm. Conclusions: A lower than expected (around 40%) frequency of latent TB infection was found among the participants. But using a cut-off value of 5 mm yields a frequency of 44%% that is close to our expectation. So a lower cut-off value for the interpretation of Mantoux test in patients with spondyloarthritis may be appropriate. A larger-scale study is required to confirm this observation.
Spondyloarthritis, Latent TB Infection, Mantoux Test
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Abu Tahir Muhammad Tanveer Hasan, Muhammad Abdul Alim, Frequency of Latent TB Infection in Patients with Spondyloarthritis in a Tertiary Care Hospital in Bangladesh, American Journal of Biomedical and Life Sciences. Vol. 8, No. 6, 2020, pp. 202-205. doi: 10.11648/j.ajbls.20200806.12
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Yu DT, van Tubergen A. Overview of the clinical manifestations and classification of spondyloarthritis. UpToDate. Sieper J, Romain PL, ed. UpToDate. Maltham, MA: UpToDate Inc. Available from: (Updated 7 September 2018, cited 17 December 2019).
Ahmed S, Haq SA, Al-Qadir AZ, Rahman MM, Paul S. Survey on prevalence of rheumatic disorders in Bangladeshi adults. Ann Rheum Dis. 2017; 76 (2): 1044-1045.
Zeidler H, Amor B. The Assessment of Spondyloarthritis International Society (ASAS) classification criteria for peripheral spondyloarthritis and for spondyloarthritis in general: the spondyloarthritis concept in progress. Ann Rheum Dis 2011; 70 (1): 25-31.
Zeidler H, Calin A, Amor B. A historical perspective of the spondyloarthritis. Curr Opin Rheumatol 2011; 23 (4): 327-333.
van der Heijde D, Ramiro S, Landewé R, Baraliakos X, Van den Bosch F, Sepriano A, Regel A, Ciurea A, Dagfinrud H, Dougados M, van Gaalen F. 2016 update of the ASAS-EULAR management recommendations for axial spondyloarthritis. Annals of the rheumatic diseases. 2017 Jun 1; 76 (6): 978-91.
Gossec L, Smolen JS, Ramiro S, De Wit M, Cutolo M, Dougados M, Emery P, Landewé R, Oliver S, Aletaha D, Betteridge N. European League Against Rheumatism (EULAR) recommendations for the management of psoriatic arthritis with pharmacological therapies: 2015 update. Annals of the rheumatic diseases. 2016 Mar 1; 75 (3): 499-510.
Kourbeti IS, Ziakas PD, Mylonakis E. Biologic therapies in rheumatoid arthritis and the risk of opportunistic infections: a meta-analysis. Clinical Infectious Diseases. 2014 Mar 18; 58 (12): 1649-57.
Winthrop KL, Park SH, Gul A, Cardiel MH, Gomez-Reino JJ, Tanaka Y, Kwok K, Lukic T, Mortensen E, de Leon DP, Riese R. Tuberculosis and other opportunistic infections in tofacitinib-treated patients with rheumatoid arthritis. Annals of the rheumatic diseases. 2016 Jun 1; 75 (6): 1133-8.
Holroyd CR, Seth R, Bukhari M, Malaviya A, Holmes C, Curtis E, Chan C, Yusuf MA, Litwic A, Smolen S, Topliffe J. The British Society for Rheumatology biologic DMARD safety guidelines in inflammatory arthritis. Rheumatology. 2018 Aug 21; 58 (2): e3-42.
Singh JA, Saag KG, Bridges Jr SL, Akl EA, Bannuru RR, Sullivan MC, Vaysbrot E, McNaughton C, Osani M, Shmerling RH, Curtis JR. 2015 American College of Rheumatology guideline for the treatment of rheumatoid arthritis. Arthritis & rheumatology. 2016 Jan; 68 (1): 1-26.
Anand NM, Vishal KA, Kalyani A, Sadhana SB. Tuberculin Skin Test for the Screening of Latent Tuberculosis Infection Before Starting Treatment with Tumour Necrosis Factor-α Inhibitors In Systemic Immunoinflammatory Rheumatic Diseases in India-A High Burden Tuberculosis Region of the World. J Rheumatol Arthritic Dis. 2018; 3 (2): 1-6.
Daniello J, Zöllner I. Experiences with the intracutaneous Mendel-Mantoux tuberculin test in routine screening in a public health office. Gesundheitswesen (Bundesverband der Arzte des Offentlichen Gesundheitsdienstes (Germany)). 1997; 59 (8-9): 519-22.
Dye C, Scheele S, Pathania V, Raviglione MC. Global burden of tuberculosis: estimated incidence, prevalence, and mortality by country. Jama. 1999 Aug 18; 282 (7): 677-86.
Islam, S., Chowdhury, S., Karim, M., Samad, R., Barua, P., & Chowdhury, Z. (2017). Prevalence of Latent Tuberculosis Among Children Living in Households with Smear Positive Pulmonary Tuberculosis Patients. Bangladesh Medical Research Council Bulletin, 42 (2), 67-71
City B. Latent tuberculosis infection among healthcare workers in chest disease hospitals. Bangladesh. Health and Science Bulletin. 2014 Mar; 12 (1).
Kanabus A. TB statistics India. UK: Global Health Education (GHE); (updated October 2019, cited 29 December 2019). Available from:
World Health Organization. Tuberculosis Country Profile – Bangladesh. Geneva: WHO; (updated 2018, cited 18 December 2019). Available from:
World Health Organization. Tuberculosis Country Profile – India. Geneva: WHO; (updated 2018, cited 19 December 2019). Available from:
Furer V, Rondaan C, Heijstek MW, Agmon-Levin N, van Assen S, Bijl M, Breedveld FC, D'Amelio R, Dougados M, Kapetanovic MC, van Laar JM. 2019 update of EULAR recommendations for vaccination in adult patients with autoimmune inflammatory rheumatic diseases. Annals of the rheumatic diseases. 2020 Jan 1; 79 (1): 39-52.
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