16 research outputs found
Aplicaci贸n de modelos bayesianos para estimar la prevalencia de enfermedad y la sensibilidad y especificidad de tests de diagn贸stico cl铆nico sin gold standard
[spa] Dos objetivos claves de la investigaci贸n diagn贸stica son estimar con exactitud y precisi贸n la prevalencia de la enfermedad y la sensibilidad y especificidad de tests diagn贸sticos. Se han desarrollado modelos de clases latentes que tienen en cuenta la correlaci贸n entre las medidas de los individuos determinadas con diferentes tests con el fin de diagnosticar enfermedades para las cuales no est谩n disponibles tests gold standard. En algunos estudios cl铆nicos, se hacen varias medidas del mismo individuo con el mismo test en las mismas condiciones y, por tanto, las mediciones replicadas para cada individuo no son independientes. En esta tesis se propone una extensi贸n Bayesiana del modelo de clases latentes de efectos aleatorios de Gauss para ajustar a los datos de tests con resultados binarios y con medidas replicadas por individuo. Se describe una aplicaci贸n que utiliza los datos recogidos de personas infectadas por par谩sitos intestinales Hookworm llevada a cabo en el municipio de Presidente Figueiredo, Estado de Amazonas en Brasil. Adem谩s, a trav茅s de un estudio de simulaci贸n se compar贸 el desempe帽o del modelo propuesto con los modelos actuales (el modelo de efectos aleatorios individuo y modelos de dependencia e independencia condicional). Como era de esperar, el modelo propuesto presenta una mayor exactitud y precisi贸n en las estimaciones de prevalencia, sensibilidad y especificidad. Para un control adecuado de las enfermedades la Organizaci贸n Mundial de la Salud ha propuesto el diagn贸stico y tratamiento de la infecci贸n tuberculosa latente (LTBI) en grupos de riesgo de desarrollar la enfermedad, como los ni帽os. No existe un test gold standard para el diagn贸stico de la infecci贸n latente. Los modelos estad铆sticos basados en la estimaci贸n de clases latentes permiten la evaluaci贸n de la prevalencia de la infecci贸n y la validez de los tests utilizados en ausencia de un gold standard. Se realiz贸 un estudio transversal con ni帽os de hasta 6 a帽os de edad que hab铆an sido vacunados con la BCG en Manaus, Amazonas-Brasil. El objetivo de dicho estudio fue estimar la prevalencia de la infecci贸n latente en los ni帽os peque帽os en contacto con un caso indice de tuberculosis en el hogar (TB-HCC) y determinar la validez y la seguridad del test cut谩neo de tuberculina (TST) y QuantiFERON-TB Gold-in-tube (QFT), utilizando modelos de clases latentes. Para las estimaciones, en una primera fase se consider贸 la correlaci贸n entre los dos tests, y en la segunda fase se consider贸 la prevalencia en funci贸n de la intensidad y del tiempo de exposici贸n. El cincuenta por ciento de los ni帽os con TB-HCC ten铆a LTBI, con la prevalencia en funci贸n del tiempo y la intensidad de la exposici贸n al caso 铆ndice. La sensibilidad y la especificidad de TST fueron del 73 % [intervalo de confianza del 95 % (IC): 53-91] y el 97 % (IC del 95 %: 89-100), respectivamente, frente al 53 % (IC del 95 %: 41-66) y el 81 % (IC del 95 %: 71-90) para QFT. El valor predictivo positivo de TST en ni帽os con TB-HCC fue del 91 % (IC del 95 %: 61-99), y para QFT fue del 74 % (IC del 95 %: 47-95). Este es uno de los primeros estudios que usa modelos de clases latentes para estimar la prevalencia de la infecci贸n por M. tuberculosis en ni帽os y los par谩metros de sus principales tests diagn贸sticos. Los resultados sugieren que los ni帽os en contacto con un caso 铆ndice tienen un alto riesgo de infecci贸n. La validez y los valores predictivos no mostraron diferencias significativas seg煤n el test aplicado. El uso combinado de los dos tests en nuestro estudio mostr贸 una sutil mejor铆a en el diagn贸stico de la LTBI.[eng] Two key aims of diagnostic research are to accurately and precisely estimate disease prevalence and test sensitivity and specificity. Latent class models have been proposed that consider the correlation between subject measures determined by different tests in order to diagnose diseases for which gold standard tests are not available. In some clinical studies, several measures of the same subject are made with the same test under the same conditions (replicated measurements) and thus, replicated measurements for each subject are not independent. In the present study, we propose an extension of the Bayesian latent class Gaussian random effects model to fit the data with binary outcomes for tests with replicated subject measures. We describe an application using data collected on hookworm infection carried out in the municipality of Presidente Figueiredo, Amazonas State, Brazil. In addition, the performance of the proposed model was compared with that of current models (the subject random effects model and the conditional (in)dependent model) through a simulation study. As expected, the proposed model presented better accuracy and precision in the estimations of prevalence, sensitivity and specificity. For adequate disease control the World Health Organization has proposed the diagnosis and treatment of latent tuberculous infection (LTBI) in groups of risk of developing the disease such as children. There is no gold standard (GS) test for the diagnosis of LTBI. Statistical models based on the estimation of latent class allow evaluation of the prevalence of infection and the accuracy of the tests used in the absence of a GS. We conducted a cross-sectional study with children up to 6 years of age who had been vaccinated with the BCG in Manaus, Amazonas- Brazil. The objective of this study was to estimate the prevalence of LTBI in young children in contact with a household case of tuberculosis (TB-HCC) and determine the accuracy and precision of the Tuberculin Skin Test (TST) and QuantiFERON-TB Gold in-tube (QFT) using the latent class model. Fifty percent of the children with TB-HCC had LTBI, with the pre- valence depending on the intensity and length of exposure to the index case. The sensitivity and specificity of TST were 73 % [95 % confidence interval (CI): 53-91] and 97 % (95 % CI: 89-100), respectively, versus 53 % (95 % CI: 41-66) and 81 % (95 % CI: 71-90) for QFT. The positive predictive value of TST in children with TB-HCC was 91 % (95 % CI: 61-99), and for QFT was 74 % (95 % CI: 47-95). This is one of the first studies to estimate the prevalence of M. tuberculosis infection in children and the parameters of its main diagnostic tests by latent class model. The results suggest that children in contact with an index case have a high risk of infection. The accuracy and the predictive values did not show significant differences according to the test applied. Combined use of the two tests in our study showed scarce improvement in the diagnosis of LTBI
Aplicaci贸n de modelos bayesianos para estimar la prevalencia de enfermedad y la sensibilidad y especificidad de tests de diagn贸stico cl铆nico sin gold standard
Dos objetivos claves de la investigaci贸n diagn贸stica son estimar con exactitud y precisi贸n la prevalencia de la enfermedad y la sensibilidad y especificidad de tests diagn贸sticos. Se han desarrollado modelos de clases latentes que tienen en cuenta la correlaci贸n entre las medidas de los individuos determinadas con diferentes tests con el fin de diagnosticar enfermedades para las cuales no est谩n disponibles tests gold standard. En algunos estudios cl铆nicos, se hacen varias medidas del mismo individuo con el mismo test en las mismas condiciones y, por tanto, las mediciones replicadas para cada individuo no son independientes. En esta tesis se propone una extensi贸n Bayesiana del modelo de clases latentes de efectos aleatorios de Gauss para ajustar a los datos de tests con resultados binarios y con medidas replicadas por individuo. Se describe una aplicaci贸n que utiliza los datos recogidos de personas infectadas por par谩sitos intestinales Hookworm llevada a cabo en el municipio de Presidente Figueiredo, Estado de Amazonas en Brasil. Adem谩s, a trav茅s de un estudio de simulaci贸n se compar贸 el desempe帽o del modelo propuesto con los modelos actuales (el modelo de efectos aleatorios individuo y modelos de dependencia e independencia condicional). Como era de esperar, el modelo propuesto presenta una mayor exactitud y precisi贸n en las estimaciones de prevalencia, sensibilidad y especificidad.
Para un control adecuado de las enfermedades la Organizaci贸n Mundial de la Salud ha propuesto el diagn贸stico y tratamiento de la infecci贸n tuberculosa latente (LTBI) en grupos de riesgo de desarrollar la enfermedad, como los ni帽os. No existe un test gold standard para el diagn贸stico de la infecci贸n latente. Los modelos estad铆sticos basados en la estimaci贸n de clases latentes permiten la evaluaci贸n de la prevalencia de la infecci贸n y la validez de los tests utilizados en ausencia de un gold standard. Se realiz贸 un estudio transversal con ni帽os de hasta 6 a帽os de edad que hab铆an sido vacunados con la BCG en Manaus, Amazonas-Brasil. El objetivo de dicho estudio fue estimar la prevalencia de la infecci贸n latente en los ni帽os peque帽os en contacto con un caso indice de tuberculosis en el hogar (TB-HCC) y determinar la validez y la seguridad del test cut谩neo de tuberculina (TST) y QuantiFERON-TB Gold-in-tube (QFT), utilizando modelos de clases latentes. Para las estimaciones, en una primera fase se consider贸 la correlaci贸n entre los dos tests, y en la segunda fase se consider贸 la prevalencia en funci贸n de la intensidad y del tiempo de exposici贸n. El cincuenta por ciento de los ni帽os con TB-HCC ten铆a LTBI, con la prevalencia en funci贸n del tiempo y la intensidad de la exposici贸n al caso 铆ndice. La sensibilidad y la especificidad de TST fueron del 73 % [intervalo de confianza del 95 % (IC): 53-91] y el 97 % (IC del 95 %: 89-100), respectivamente, frente al 53 % (IC del 95 %: 41-66) y el 81 % (IC del 95 %: 71-90) para QFT. El valor predictivo positivo de TST en ni帽os con TB-HCC fue del 91 % (IC del 95 %: 61-99), y para QFT fue del 74 % (IC del 95 %: 47-95). Este es uno de los primeros estudios que usa modelos de clases latentes para estimar la prevalencia de la infecci贸n por M. tuberculosis en ni帽os y los par谩metros de sus principales tests diagn贸sticos. Los resultados sugieren que los ni帽os en contacto con un caso 铆ndice tienen un alto riesgo de infecci贸n. La validez y los valores predictivos no mostraron diferencias significativas seg煤n el test aplicado. El uso combinado de los dos tests en nuestro estudio mostr贸 una sutil mejor铆a en el diagn贸stico de la LTBI.Two key aims of diagnostic research are to accurately and precisely estimate disease prevalence and test sensitivity and specificity. Latent class models have been proposed that consider the correlation between subject measures determined by different tests in order to diagnose diseases for which gold standard tests are not available. In some clinical studies, several measures of the same subject are made with the same test under the same conditions (replicated measurements) and thus, replicated measurements for each subject are not independent. In the present study, we propose an extension of the Bayesian latent class Gaussian random effects model to fit the data with binary outcomes for tests with replicated subject measures. We describe an application using data collected on hookworm infection carried out in the municipality of Presidente Figueiredo, Amazonas State, Brazil. In addition, the performance of the proposed model was compared with that of current models (the subject random effects model and the conditional (in)dependent model) through a simulation study. As expected, the proposed model presented better accuracy and precision in the estimations of prevalence, sensitivity and specificity.
For adequate disease control the World Health Organization has proposed the diagnosis and treatment of latent tuberculous infection (LTBI) in groups of risk of developing the disease such as children. There is no gold standard (GS) test for the diagnosis of LTBI. Statistical models based on the estimation of latent class allow evaluation of the prevalence of infection and the accuracy of the tests used in the absence of a GS. We conducted a cross-sectional study with children up to 6 years of age who had been vaccinated with the BCG in Manaus, Amazonas- Brazil. The objective of this study was to estimate the prevalence of LTBI in young children in contact with a household case of tuberculosis (TB-HCC) and determine the accuracy and precision of the Tuberculin Skin Test (TST) and QuantiFERON-TB Gold in-tube (QFT) using the latent class model. Fifty percent of the children with TB-HCC had LTBI, with the pre- valence depending on the intensity and length of exposure to the index case. The sensitivity and specificity of TST were 73 % [95 % confidence interval (CI): 53-91] and 97 % (95 % CI: 89-100), respectively, versus 53 % (95 % CI: 41-66) and 81 % (95 % CI: 71-90) for QFT. The positive predictive value of TST in children with TB-HCC was 91 % (95 % CI: 61-99), and for QFT was 74 % (95 % CI: 47-95). This is one of the first studies to estimate the prevalence of M. tuberculosis infection in children and the parameters of its main diagnostic tests by latent class model. The results suggest that children in contact with an index case have a high risk of infection. The accuracy and the predictive values did not show significant differences according to the test applied. Combined use of the two tests in our study showed scarce improvement in the diagnosis of LTBI
Prevalence and Diagnosis of Latent Tuberculosis Infection in Young Children in the Absence of a Gold Standard
Introduction For adequate disease control the World Health Organization has proposed the diagnosis and treatment of latent tuberculous infection (LTBI) in groups of risk of developing the disease such as children. There is no gold standard (GS) test for the diagnosis of LTBI. The objective of this study was to estimate the prevalence of LTBI in young children in contact with a household case of tuberculosis (TB-HCC) and determine the accuracy and precision of the Tuberculin Skin Test (TST) and QuantiFERON-TB Gold in-tube (QFT) used in the absence of a GS. Methods We conducted a cross-sectional study in children up to 6 years of age in Manaus/Brazil during the years 2009-2010. All the children had been vaccinated with the BCG and were classified into two groups according to the presence of a TB-HCC or no known contact with tuberculosis (TB). The variables studied were: the TST and QFT results and the intensity and length of exposure to the index tuberculosis case. We used the latent class model to determine the prevalence of LTBI and the accuracy of the tests. Results Fifty percent of the children with TB-HCC had LTBI, with the prevalence depending on the intensity and length of exposure to the index case. The sensitivity and specificity of TST were 73% [95% confidence interval (CI): 53-91] and 97% (95%CI: 89-100), respectively, versus 53% (95%CI: 41-66) and 81% (95%CI:71-90) for QFT. The positive predictive value of TST in children with TB-HCC was 91% (95%CI: 61-99), being 74% for QFT (95%CI: 47-95). Conclusions This is one of the first studies to estimate the prevalence of LTBI in children and the parameters of the main diagnostic tests using a latent class model. Our results suggest that children in contact with an index case have a high risk of infection. The accuracy and the predictive value of the two tests did not significantly differ. Combined use of the two tests showed scarce improvement in the diagnosis of LTBI
Aplicaci贸n de modelos bayesianos para estimar la prevalencia de enfermedad y la sensibilidad y especificidad de tests de diagn贸stico cl铆nico sin gold standard
Dos objetivos claves de la investigaci贸n diagn贸stica son estimar con exactitud y precisi贸n la prevalencia de la enfermedad y la sensibilidad y especificidad de tests diagn贸sticos. Se han desarrollado modelos de clases latentes que tienen en cuenta la correlaci贸n entre las medidas de los individuos determinadas con diferentes tests con el fin de diagnosticar enfermedades para las cuales no est谩n disponibles tests gold standard. En algunos estudios cl铆nicos, se hacen varias medidas del mismo individuo con el mismo test en las mismas condiciones y, por tanto, las mediciones replicadas para cada individuo no son independientes. En esta tesis se propone una extensi贸n Bayesiana del modelo de clases latentes de efectos aleatorios de Gauss para ajustar a los datos de tests con resultados binarios y con medidas replicadas por individuo. Se describe una aplicaci贸n que utiliza los datos recogidos de personas infectadas por par谩sitos intestinales Hookworm llevada a cabo en el municipio de Presidente Figueiredo, Estado de Amazonas en Brasil. Adem谩s, a trav茅s de un estudio de simulaci贸n se compar贸 el desempe帽o del modelo propuesto con los modelos actuales (el modelo de efectos aleatorios individuo y modelos de dependencia e independencia condicional). Como era de esperar, el modelo propuesto presenta una mayor exactitud y precisi贸n en las estimaciones de prevalencia, sensibilidad y especificidad.
Para un control adecuado de las enfermedades la Organizaci贸n Mundial de la Salud ha propuesto el diagn贸stico y tratamiento de la infecci贸n tuberculosa latente (LTBI) en grupos de riesgo de desarrollar la enfermedad, como los ni帽os. No existe un test gold standard para el diagn贸stico de la infecci贸n latente. Los modelos estad铆sticos basados en la estimaci贸n de clases latentes permiten la evaluaci贸n de la prevalencia de la infecci贸n y la validez de los tests utilizados en ausencia de un gold standard. Se realiz贸 un estudio transversal con ni帽os de hasta 6 a帽os de edad que hab铆an sido vacunados con la BCG en Manaus, Amazonas-Brasil. El objetivo de dicho estudio fue estimar la prevalencia de la infecci贸n latente en los ni帽os peque帽os en contacto con un caso indice de tuberculosis en el hogar (TB-HCC) y determinar la validez y la seguridad del test cut谩neo de tuberculina (TST) y QuantiFERON-TB Gold-in-tube (QFT), utilizando modelos de clases latentes. Para las estimaciones, en una primera fase se consider贸 la correlaci贸n entre los dos tests, y en la segunda fase se consider贸 la prevalencia en funci贸n de la intensidad y del tiempo de exposici贸n. El cincuenta por ciento de los ni帽os con TB-HCC ten铆a LTBI, con la prevalencia en funci贸n del tiempo y la intensidad de la exposici贸n al caso 铆ndice. La sensibilidad y la especificidad de TST fueron del 73 % [intervalo de confianza del 95 % (IC): 53-91] y el 97 % (IC del 95 %: 89-100), respectivamente, frente al 53 % (IC del 95 %: 41-66) y el 81 % (IC del 95 %: 71-90) para QFT. El valor predictivo positivo de TST en ni帽os con TB-HCC fue del 91 % (IC del 95 %: 61-99), y para QFT fue del 74 % (IC del 95 %: 47-95). Este es uno de los primeros estudios que usa modelos de clases latentes para estimar la prevalencia de la infecci贸n por M. tuberculosis en ni帽os y los par谩metros de sus principales tests diagn贸sticos. Los resultados sugieren que los ni帽os en contacto con un caso 铆ndice tienen un alto riesgo de infecci贸n. La validez y los valores predictivos no mostraron diferencias significativas seg煤n el test aplicado. El uso combinado de los dos tests en nuestro estudio mostr贸 una sutil mejor铆a en el diagn贸stico de la LTBI.Two key aims of diagnostic research are to accurately and precisely estimate disease prevalence and test sensitivity and specificity. Latent class models have been proposed that consider the correlation between subject measures determined by different tests in order to diagnose diseases for which gold standard tests are not available. In some clinical studies, several measures of the same subject are made with the same test under the same conditions (replicated measurements) and thus, replicated measurements for each subject are not independent. In the present study, we propose an extension of the Bayesian latent class Gaussian random effects model to fit the data with binary outcomes for tests with replicated subject measures. We describe an application using data collected on hookworm infection carried out in the municipality of Presidente Figueiredo, Amazonas State, Brazil. In addition, the performance of the proposed model was compared with that of current models (the subject random effects model and the conditional (in)dependent model) through a simulation study. As expected, the proposed model presented better accuracy and precision in the estimations of prevalence, sensitivity and specificity.
For adequate disease control the World Health Organization has proposed the diagnosis and treatment of latent tuberculous infection (LTBI) in groups of risk of developing the disease such as children. There is no gold standard (GS) test for the diagnosis of LTBI. Statistical models based on the estimation of latent class allow evaluation of the prevalence of infection and the accuracy of the tests used in the absence of a GS. We conducted a cross-sectional study with children up to 6 years of age who had been vaccinated with the BCG in Manaus, Amazonas- Brazil. The objective of this study was to estimate the prevalence of LTBI in young children in contact with a household case of tuberculosis (TB-HCC) and determine the accuracy and precision of the Tuberculin Skin Test (TST) and QuantiFERON-TB Gold in-tube (QFT) using the latent class model. Fifty percent of the children with TB-HCC had LTBI, with the pre- valence depending on the intensity and length of exposure to the index case. The sensitivity and specificity of TST were 73 % [95 % confidence interval (CI): 53-91] and 97 % (95 % CI: 89-100), respectively, versus 53 % (95 % CI: 41-66) and 81 % (95 % CI: 71-90) for QFT. The positive predictive value of TST in children with TB-HCC was 91 % (95 % CI: 61-99), and for QFT was 74 % (95 % CI: 47-95). This is one of the first studies to estimate the prevalence of M. tuberculosis infection in children and the parameters of its main diagnostic tests by latent class model. The results suggest that children in contact with an index case have a high risk of infection. The accuracy and the predictive values did not show significant differences according to the test applied. Combined use of the two tests in our study showed scarce improvement in the diagnosis of LTBI
Prevalence and Diagnosis of Latent Tuberculosis Infection in Young Children in the Absence of a Gold Standard.
For adequate disease control the World Health Organization has proposed the diagnosis and treatment of latent tuberculous infection (LTBI) in groups of risk of developing the disease such as children. There is no gold standard (GS) test for the diagnosis of LTBI. The objective of this study was to estimate the prevalence of LTBI in young children in contact with a household case of tuberculosis (TB-HCC) and determine the accuracy and precision of the Tuberculin Skin Test (TST) and QuantiFERON-TB Gold in-tube (QFT) used in the absence of a GS.We conducted a cross-sectional study in children up to 6 years of age in Manaus/Brazil during the years 2009-2010. All the children had been vaccinated with the BCG and were classified into two groups according to the presence of a TB-HCC or no known contact with tuberculosis (TB). The variables studied were: the TST and QFT results and the intensity and length of exposure to the index tuberculosis case. We used the latent class model to determine the prevalence of LTBI and the accuracy of the tests.Fifty percent of the children with TB-HCC had LTBI, with the prevalence depending on the intensity and length of exposure to the index case. The sensitivity and specificity of TST were 73% [95% confidence interval (CI): 53-91] and 97% (95%CI: 89-100), respectively, versus 53% (95%CI: 41-66) and 81% (95%CI:71-90) for QFT. The positive predictive value of TST in children with TB-HCC was 91% (95%CI: 61-99), being 74% for QFT (95%CI: 47-95).This is one of the first studies to estimate the prevalence of LTBI in children and the parameters of the main diagnostic tests using a latent class model. Our results suggest that children in contact with an index case have a high risk of infection. The accuracy and the predictive value of the two tests did not significantly differ. Combined use of the two tests showed scarce improvement in the diagnosis of LTBI
Metronidazole and amoxicillin for patients with periodontitis and diabetes mellitus: 5 years secondary analysis of a randomized controlled trial
Prevalence and Diagnosis of Latent Tuberculosis Infection in Young Children in the Absence of a Gold Standard
Introduction For adequate disease control the World Health Organization has proposed the diagnosis and treatment of latent tuberculous infection (LTBI) in groups of risk of developing the disease such as children. There is no gold standard (GS) test for the diagnosis of LTBI. The objective of this study was to estimate the prevalence of LTBI in young children in contact with a household case of tuberculosis (TB-HCC) and determine the accuracy and precision of the Tuberculin Skin Test (TST) and QuantiFERON-TB Gold in-tube (QFT) used in the absence of a GS. Methods We conducted a cross-sectional study in children up to 6 years of age in Manaus/Brazil during the years 2009-2010. All the children had been vaccinated with the BCG and were classified into two groups according to the presence of a TB-HCC or no known contact with tuberculosis (TB). The variables studied were: the TST and QFT results and the intensity and length of exposure to the index tuberculosis case. We used the latent class model to determine the prevalence of LTBI and the accuracy of the tests. Results Fifty percent of the children with TB-HCC had LTBI, with the prevalence depending on the intensity and length of exposure to the index case. The sensitivity and specificity of TST were 73% [95% confidence interval (CI): 53-91] and 97% (95%CI: 89-100), respectively, versus 53% (95%CI: 41-66) and 81% (95%CI:71-90) for QFT. The positive predictive value of TST in children with TB-HCC was 91% (95%CI: 61-99), being 74% for QFT (95%CI: 47-95). Conclusions This is one of the first studies to estimate the prevalence of LTBI in children and the parameters of the main diagnostic tests using a latent class model. Our results suggest that children in contact with an index case have a high risk of infection. The accuracy and the predictive value of the two tests did not significantly differ. Combined use of the two tests showed scarce improvement in the diagnosis of LTBI
Probability of non LTBI (LTBI<sup>c</sup>) in children up to 6 years of age according to the results of both tests in the latent class model (first phase).
<p>Probability of non LTBI (LTBI<sup>c</sup>) in children up to 6 years of age according to the results of both tests in the latent class model (first phase).</p
Probability of LTBI in children up to 6 years of age according to the results of both tests in the latent class model (first phase).
<p>Probability of LTBI in children up to 6 years of age according to the results of both tests in the latent class model (first phase).</p
Flow diagram of enrollment.
<p>TB: tuberculosis, QFT: QuantiFERON-TB Gold In-Tube, TST: Tuberculin Skin Test.</p