Scary Actions You'll Be Able To Do With PRDX5

157 A study in Caucasian residents of old age homes in South Africa showed rates of 798/100?000 population, compared with 16/100?000 in the general population.158 A study from Hong Kong in 1993 showed rates of 1200�C2600/100?000 in care homes compared with 100�C400/100?000 in the general elderly population. Other studies have, however, shown no increased risk in the elderly in such settings.132,159 In the USA in 1984�C1985 a study showed an incidence of 39.2/100?000 among nursing home residents, compared with 21.5/100?000 in those living in the community. The Centers for Disease Control and Prevention in the USA has established recommendations for surveillance, control and reporting of TB in long-term care facilities.1 All new residents and employees have an initial TST and then annual screening. Chest radiography is performed on all Tariquidar solubility dmso those with a positive TST. As noted earlier TB case rates are highest in ��65-year age group Autophagy inhibitor in the USA. In 1989 the strategic plan for elimination of TB in the USA stated that ��control and prevention of TB among the elderly must be addressed aggressively to achieve the goal of eliminating TB in the United States by the year 2010��.160 In the USA, more elderly persons live in nursing homes than in any other type of residential institution; approximately 5% of all elderly persons live in a nursing home. However, elderly persons represent 88% of the nation's approximately 1.7 million nursing home residents.161 Such concentrations of elderly persons, many of whom have latent TB and some of whom are immunosuppressed, create high-risk situations for TB transmission. The results of a recent prospective observational study in the USA (entry closed January 2009) are awaited. This study set out to compare the TST with IGRA (T-SPOT.TB, Oxford Immunotec, Oxford, UK) testing for the screening of patients ��65?years old in USA nursing homes. The usefulness of TST depends on the prevalence within and the age of a particular population. Universal guidance on screening is not possible as this will vary depending on the prevalence PRDX5 within a country. Where the prevalence is high sputum examination and chest radiography remain the most cost-effective screening method. Screening using TST, IGRA, sputum smear and culture, and chest radiography may be considered. This screening policy was advocated in the USA in 1989.160 Methods of screening vary across Europe and screening of the elderly in long-term facilities only occurs in 16/50 (32%) of European countries.162 In general the adverse effects of treatment for latent TB in the elderly outweigh the potential benefits of disease prevention. If it is believed that the elderly have an increased susceptibility; surveillance and screening should be considered to be paramount if we are to eliminate TB worldwide.1 A study from Hong Kong showed that when screening an elderly population for TB, low BMI (