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Wang et al1 are right when they underline the need to adjust for confounding variables when analysing the results of a tuberculin skin test (TST) survey, but they are oversimplistic when, using surveys done in many countries worldwide, they study only the effect of the BCG vaccination on the TST results. The authors did not discuss the rate of atypical mycobacterial infection in a population, an important confounding factor that drives up the rate of tuberculous infection, because atypical mycobacteria crossreact with Mycobacterium tuberculosis. Unlike Wang et al …
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