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Journal of Family Medicine and Primary... Feb 2022Tuberculosis (TB) is one of the main causes of mortality among infectious diseases. The prevalence of tuberculosis is very high in developing countries such as India....
BACKGROUND
Tuberculosis (TB) is one of the main causes of mortality among infectious diseases. The prevalence of tuberculosis is very high in developing countries such as India. Mantoux test is frequently used for the diagnosis of latent or active tuberculosis despite low sensitivity and specificity. However, the Mantoux test is a crucial test in a resource-less setup for the diagnosis of TB. Therefore, the main purpose of this study was to find the dropout rate and dropout reasons in Mantoux testing.
METHODOLOGY
All suspected TB patients attending out-patient department and further tested for Mantoux test.
RESULTS
Of the total 789 Mantoux tests, 459 (58%) were negative, 195 (25%) were positive, and 135 (17%) were dropouts. One of the main reasons for dropout was patients did not give importance to the Mantoux test.
CONCLUSION
Dropout rate in Mantoux testing can be reduced by patient counseling regarding TB and Mantoux test by the doctor.
PubMed: 35360823
DOI: 10.4103/jfmpc.jfmpc_1355_21 -
Immunology Letters Nov 2006The Mantoux Test (MT) is a classical delayed-type hypersensitivity (DTH) response to the intradermal injection of tuberculin purified protein derivative (PPD). It... (Review)
Review
The Mantoux Test (MT) is a classical delayed-type hypersensitivity (DTH) response to the intradermal injection of tuberculin purified protein derivative (PPD). It represents a cutaneous T cell mediated memory recall immune response. The test is typically used to determine immunity to tuberculosis in humans and positive reactions develop in individuals previously exposed to Mycobacterium tuberculosis, and those immunised with the Bacillus of Calmette and Guérin (BCG) vaccine. In view of its relative accessibility human skin represents a convenient tissue for the investigation of human immune responses. Using the MT, we have been able to determine that significant cellular proliferation and clonal expansion occur at the site of antigen deposition in the skin. Furthermore, cells undergoing proliferation in the skin also undergo accelerated differentiation. Taken together with other studies, in humans and in mice, these observations shed new light on the importance of the microenvironment at the site of the immune response for the proliferation and differentiation of memory T cells.
Topics: Animals; Humans; Immunologic Memory; Intradermal Tests; Lymphocyte Activation; Mice; Models, Biological; Skin; T-Lymphocytes; Tuberculin Test
PubMed: 16979761
DOI: 10.1016/j.imlet.2006.08.002 -
Canadian Family Physician Medecin de... Jan 1999
Review
Topics: Adult; Child, Preschool; Diagnostic Errors; False Negative Reactions; Female; Humans; Infant; Infant, Newborn; Risk Factors; Time Factors; Tuberculin Test
PubMed: 10928799
DOI: No ID Found -
Indian Dermatology Online Journal Jan 2012The tuberculin skin test is one of the few investigations dating from the 19(th) century that are still widely used as an important test for diagnosing tuberculosis....
The tuberculin skin test is one of the few investigations dating from the 19(th) century that are still widely used as an important test for diagnosing tuberculosis. Though very commonly used by physicians worldwide its interpretation always remains difficult and controversial. Various factors like age, immunological status coexisting illness etc influence its outcome, so also its interpretation. Utmost care is required while interpreting the result and giving an opinion. This article has been written with the purpose of elucidating the performance and interpretation of the standard tuberculin test.
PubMed: 23130251
DOI: 10.4103/2229-5178.93479 -
Journal of Maxillofacial and Oral... Jun 2021This retrospective study evaluates the importance of Mantoux test and Erythrocyte Sedimentation Rate (ESR) levels in pediatric tuberculosis and also signifies the impact...
AIMS AND OBJECTIVE
This retrospective study evaluates the importance of Mantoux test and Erythrocyte Sedimentation Rate (ESR) levels in pediatric tuberculosis and also signifies the impact of this test in treatment planning and implementation in pediatric cleft lip and palate patients.
METHODOLOGY
Retrospective analyses of the records of 2010 pediatric cleft lip and palate patients below 5 years age were performed, and patients with elevated ESR subjected to Mantoux test were identified. The parameters included were age, sex, ESR levels, type of cleft, history of contact with TB & BCG vaccination, Mantoux conversion, chest X-ray findings, number of smear-positive pulmonary tuberculosis.
RESULTS
Out of 2010 patients with cleft lip and palate, 180 patients were subjected to Mantoux test due to high ESR levels. Among these, 54 (30%) patients found as Mantoux positive, in which 45 patients were identified as smear-positive pulmonary tuberculosis patients; as a result, surgery was deferred and they underwent antituberculous therapy. Most of the Mantoux-positive cases were found in patients with ESR range of 20-30 mm, i.e., 38 patients (71%), and common age group was 6 months-1 year. The most commonly involved cleft type was: unilateral cleft lip and palate having 36 patients (66.7%). The overall incidence of tuberculosis was 2%.
CONCLUSION
Although the correlation of Mantoux test with elevated ESR was not significant in our study, it could be of value as a screening tool along with the Mantoux test, which is sensitive but nonspecific in the diagnosis of active tuberculosis. Together, they could be a valuable screening tool in any community or hospital for diagnosis of the disease.
PubMed: 33927497
DOI: 10.1007/s12663-020-01348-5 -
Journal of Infection in Developing... Aug 2018Mantoux test aids in the diagnosis of tuberculosis (TB), however its application and interpretation are dependent on multiple factors. (Observational Study)
Observational Study
INTRODUCTION
Mantoux test aids in the diagnosis of tuberculosis (TB), however its application and interpretation are dependent on multiple factors.
METHODOLOGY
A prospective study enrolling 400 children (aged 2-12) suspected to have tuberculosis. All participants received Mantoux test with two different strengths (1 TU and 5 TU) of Purified Protein Derivative (PPD) on different forearms. The test was read by two readers after 48 ± 2 and 72 ± 2 hours. Primary outcome was difference in the size of induration when read by two readers (interobserver variability). Secondary outcomes were difference in the size of induration at different intervals, with different strengths of PPD and percentage positivity of Mantoux test in TB patients.
RESULTS
Statistically significant difference was seen in the size of induration when read by two different readers, with fair to moderate agreement when read at 48 and 72 hours (1 TU: p = 0.002, k = 0.52 and p = 0.1, k = 0.73 respectively, 5 TU: p = 0.001, k = 0.39 and p = 0.0009, k = 0.33 respectively). Tendency of under-reading occurred when size of induration was close to significant level (10-14 mm). Size of induration was similar when read at 48 or 72 hours (1 TU: p = 0.9, 5 TU: p = 1.0). Mantoux positivity rate in patients with TB was more with 5 TU as compared to 1 TU (61.2% vs. 16.3%).
CONCLUSIONS
There is significant interobserver variability with a tendency to under-read around the cutoff point. The use of 5 TU PPD at 48 hours by a trained physician can aid in early and more reliable diagnosis of TB.
Topics: BCG Vaccine; Child; Child, Preschool; Female; Humans; Male; Observer Variation; Prospective Studies; Tuberculin Test; Tuberculosis; Tuberculosis, Meningeal; Tuberculosis, Pulmonary
PubMed: 31958324
DOI: 10.3855/jidc.9601 -
Indian Journal of Pediatrics Sep 2017
Topics: Humans; Tuberculin; Tuberculin Test; Tuberculosis
PubMed: 28799024
DOI: 10.1007/s12098-017-2451-9 -
British Medical Journal May 1943
PubMed: 20784833
DOI: 10.1136/bmj.1.4297.603 -
Scandinavian Journal of Infectious... Jan 2011Abstract We conducted a study of Mantoux reactions in children managed for tuberculosis (TB) at the University of Maiduguri Teaching Hospital (UMTH) over a period of 4...
Abstract We conducted a study of Mantoux reactions in children managed for tuberculosis (TB) at the University of Maiduguri Teaching Hospital (UMTH) over a period of 4 y. Of the 97 eligible children managed for various forms of TB on whom a Mantoux test was conducted, 82 (84.5%) had a negative Mantoux reaction and 15 (15.5%) had a positive reaction. No statistically significant difference was found in relation to age groups and sex between the patients with positive and negative Mantoux reactions (p = 0.602 and p = 0.484, respectively). No significant difference in Mantoux reaction was observed among BCG-vaccinated and non-vaccinated children (p = 0.321). Although malnutrition and HIV infection were significantly associated with a negative Mantoux reaction, disseminated TB was not associated. We therefore recommend proper clinical assessment and other investigations for the diagnosis of TB in children in settings with a high prevalence of HIV infection and malnutrition, as Mantoux reaction results may be unreliable.
Topics: Adolescent; Child; Child, Preschool; False Negative Reactions; Female; HIV Infections; Humans; Infant; Male; Malnutrition; Nigeria; Tuberculin Test; Tuberculosis
PubMed: 20849365
DOI: 10.3109/00365548.2010.515606 -
International Journal of Gynaecology... Feb 2001To analyze the usefulness of the Mantoux test in the diagnosis of genital tuberculosis in women of childbearing age. (Clinical Trial)
Clinical Trial Comparative Study
OBJECTIVE
To analyze the usefulness of the Mantoux test in the diagnosis of genital tuberculosis in women of childbearing age.
METHOD
In this report, the investigators studied the ability of a tuberculosis (TB) Mantoux test to diagnose pelvic tuberculosis. A positive TB Mantoux test was clearly defined. The positive control group was of 100 women treated for TB (study group C). The negative control group was of 100 postpartum women (study group B). The study group was 100 infertile women undergoing laparoscopy, in some of whom the diagnosis of TB was made (study group A).
RESULT
The Mantoux test had a sensitivity of only 55% and a specificity of 80% in women with laparoscopically diagnosed tuberculosis. Pelvic focal reaction was absent in all groups including infertile women with a positive Mantoux test.
CONCLUSION
Mantoux test has limited utility in diagnosing active genital tuberculosis during the childbearing age. However, in infertile women with positive a Mantoux test, laparoscopy may be advocated early.
Topics: Adult; Female; Humans; Incidence; Infertility; Middle Aged; Mycobacterium tuberculosis; Reference Values; Risk Assessment; Sensitivity and Specificity; Tuberculin Test; Tuberculosis, Female Genital
PubMed: 11166750
DOI: 10.1016/s0020-7292(00)00328-3