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The Dartmouth
March 29, 2024 | Latest Issue
The Dartmouth

Students participate in TB test clinic

Dick's House is studying the effectiveness of T-SPOT, a new blood test for tuberculosis. The 125 student participants who have signed up to take part in the study will receive $25 compensation.
Dick's House is studying the effectiveness of T-SPOT, a new blood test for tuberculosis. The 125 student participants who have signed up to take part in the study will receive $25 compensation.

"The skin test is an imperfect test because it requires the patient to come in twice, and is prone to variation on how it is placed and read by the health-care worker," Talbot said. "The blood test is a single patient encounter and has a clear positive and negative cutoff."

New Hampshire and Vermont are ideal locations to test the specificity of the technology -- the test's ability to definitively rule out the presence of TB infection -- because of the region's low incidences of TB, Talbot said. Testing 200 students (125 have signed up to date) would give the study a good sample of the blood test's performance in low-risk settings, she added. Participants are subjected to both a skin and blood test and are in turn compensated $25.

"We need accurate tests for TB and [latent TB infections]," Talbot said. "There are many places where these blood tests are being researched, but our setting is unique because we have such a low rate of TB. Our goal is to see how these tests work in patients with very low risk of disease."

Talbot, who has been involved in a number of TB studies, said she approached Oxford Immunotech, the company that developed the test, and asked for support in researching latent TB in low-risk individuals. She has already studied several populations of higher-risk individuals in New Hampshire, including refugees, those exposed to active TB and certain Dartmouth students who are at higher risk of infection.

"Every year, we have students coming in who have a background of living in places where there is TB," Dawn Harland, associate director for clinical affairs at College Health Service, said. "That always creates a lot of concern whether they need the skin test or not, and the reliability of the skin test is always in question. We're hoping this test may be the end of all this worry."

The blood test, unlike the skin test, does not cross-react with other kinds of micro-bacteria, according to Talbot. Individuals who have been vaccinated for TB can falsely react to the skin test, but would not have a similar reaction with a blood test.

Most studies of the new screening have been conducted in places where TB is common. Talbot is interested in researching LTBI, a form of TB that infects a third of the world population. Although this rate is much lower in the United States, she said there is a 10 percent lifetime risk of developing the potentially fatal form of active TB from LTBI.

"TB is the third leading cause of the death in the world," she said. "In many settings in the world, diagnosis and treatment are not available. TB is particularly devastating in settings where HIV is also epidemic -- TB is the leading cause of death among HIV-infected patients worldwide."

Dartmouth students interested in the study seemed to value their potential role in the research more than the monetary incentive, according to Harland.

"Even though this study doesn't necessarily have a direct impact on global health, this campus has so many globally conscious people that it attracts attention because it's about TB," she said.