Ana Paula C Marques1, Sandra Maria V L Oliveira2, Grazielli R Rezende2, Dayane A Melo2, Sonia M Fernandes-Fitts2, Elenir Rose J C Pontes2, Maria da Glória Bonecini-Almeida3, Zoilo P Camargo4, Rinaldo P Mendes5, Anamaria M M Paniago2. 1. Faculty of Medicine, Federal University of Mato Grosso do Sul, Cidade Universitária s/n, Campo Grande, 79070-900, Brazil. apcmarques@hotmail.com. 2. Faculty of Medicine, Federal University of Mato Grosso do Sul, Cidade Universitária s/n, Campo Grande, 79070-900, Brazil. 3. Laboratory of Immunology and Immunogenetics, Evandro Chagas Clinical Research Institute, Oswaldo Cruz Foundation, Rio de Janeiro, 21040-360, Brazil. 4. Laboratory of Medical Mycology, Clinical Hospital, Faculty of Medicine, Federal University of São Paulo, São Paulo, 04023-062, Brazil. 5. Tropical Disease Department, Faculty of Medicine of Botucatu, Paulista State University, Botucatu, Brazil.
Abstract
BACKGROUND: We estimated the occurrence rate of the booster phenomenon by using an intradermal test with 43 kDa glycoprotein in an endemic area of paracoccidioidomycosis in the central-west region of Brazil. METHODS: Individuals who had a negative result on a survey performed by using an intradermal test with 43 kDa glycoprotein in an endemic area of paracoccidioidomycosis underwent a second intradermal test after 10-15 days to determine the presence or absence of the booster phenomenon. Statistical analyses were performed using the Chi-square test, Chi-square for linear trend test, Student's t test, and binomial test; p < 0.05 was considered significant. RESULTS: For the first time, we reported the occurrence of the booster phenomenon to an intradermal reaction caused by 43 kDa glycoprotein at a rate of 5.8-8.4%, depending on the test's cutoff point. This suggests that a cutoff point should be considered for the booster phenomenon in intradermal tests with 43 kDa glycoprotein: a difference of 6-7 mm between readings according to the first and second tests, depending on the purpose of the evaluation. CONCLUSION: The results indicate that the prevalence of paracoccidioidal infection in endemic areas is underestimated, as the booster phenomenon has not been considered in epidemiological surveys for this infection.
BACKGROUND: We estimated the occurrence rate of the booster phenomenon by using an intradermal test with 43 kDa glycoprotein in an endemic area of paracoccidioidomycosis in the central-west region of Brazil. METHODS: Individuals who had a negative result on a survey performed by using an intradermal test with 43 kDa glycoprotein in an endemic area of paracoccidioidomycosis underwent a second intradermal test after 10-15 days to determine the presence or absence of the booster phenomenon. Statistical analyses were performed using the Chi-square test, Chi-square for linear trend test, Student's t test, and binomial test; p < 0.05 was considered significant. RESULTS: For the first time, we reported the occurrence of the booster phenomenon to an intradermal reaction caused by 43 kDa glycoprotein at a rate of 5.8-8.4%, depending on the test's cutoff point. This suggests that a cutoff point should be considered for the booster phenomenon in intradermal tests with 43 kDa glycoprotein: a difference of 6-7 mm between readings according to the first and second tests, depending on the purpose of the evaluation. CONCLUSION: The results indicate that the prevalence of paracoccidioidal infection in endemic areas is underestimated, as the booster phenomenon has not been considered in epidemiological surveys for this infection.
Authors: Ana Paula da C Marques; Sandra Maria V L Oliveira; Grazielli R Rezende; Dayane A Melo; Sonia M Fernandes-Fitts; Elenir Rose J C Pontes; Maria da Glória Bonecini-Almeida; Zoilo P Camargo; Anamaria M M Paniago Journal: Mycopathologia Date: 2013-04-24 Impact factor: 2.574
Authors: E M N Kalmar; F E C Alencar; F P Alves; L W Pang; G M B Del Negro; Z P Camargo; M A Shikanai-Yasuda Journal: Am J Trop Med Hyg Date: 2004-07 Impact factor: 2.345