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Indian Journal of Pediatrics Jan 2001Although tuberculin test is widely used for detection of tuberculous infection among children, there is no clear understanding about its performance and interpretation.... (Review)
Review
Although tuberculin test is widely used for detection of tuberculous infection among children, there is no clear understanding about its performance and interpretation. This article has been written with the purpose of elucidating the performance and interpretation of standard tuberculin test, based on the experiences gained at the National Tuberculosis Institute, Bangalore and other centres. The standard tuberculin test involves intradermal injection of '1TU PPD RT23 with Tween 80' on the mid-volar aspect of forearm and measurement of the maximum transverse diameter of induration after 3 days. Larger the size of induration, higher is the probability of it being due to tuberculous infection. The majority of reactions with induration size of 15 mm and above are attributable to infection with tubercle bacilli, irrespective of BCG-vaccination status. While indurations of less than 5 mm indicate absence of any kind of tuberculin sensitivity, the majority of indurations in 5-9 mm range are usually of non-tuberculous nature. An induration of 10-14 mm requires more careful interpretation. It is more likely to be attributable to infection with tubercle bacilli in case of history of contact with smear positive case or among children with clinical findings of tuberculosis. However, the size of induration in an infected child may be diminished in the presence of immuno-suppressive conditions. One should also consider the purpose of the test while interpreting the test results.
Topics: BCG Vaccine; Child; Humans; Hypersensitivity, Delayed; Tuberculin Test
PubMed: 11237237
DOI: 10.1007/BF02728860 -
Veterinary Microbiology May 1994Tuberculin tests in general use today rely on the response to intradermal injections of tuberculin with assessment of the injection site for swelling at 72 hours post... (Review)
Review
Tuberculin tests in general use today rely on the response to intradermal injections of tuberculin with assessment of the injection site for swelling at 72 hours post injection. Estimates of the sensitivity of tuberculin tests range from 68-95% while specificity is estimated to be 96-99%. The sensitivity of the test is affected by the potency and dose of tuberculin administered, the interval post-infection, desensitisation, deliberate interference, post-partum immunosuppression and observer variation. Specificity is influenced by sensitisation as a result of exposure to M. avium, M. paratuberculosis and environmental mycobacteria and by skin tuberculosis.
Topics: Animals; Cattle; False Negative Reactions; False Positive Reactions; Sensitivity and Specificity; Tuberculin; Tuberculin Test; Tuberculosis, Bovine
PubMed: 8073619
DOI: 10.1016/0378-1135(94)90050-7 -
Clinical Infectious Diseases : An... Dec 1993
Review
Topics: Adult; Child; Diagnostic Errors; Female; Humans; Hypersensitivity, Delayed; Infant; Pregnancy; Reference Standards; Sensitivity and Specificity; Tuberculin; Tuberculin Test; Tuberculosis
PubMed: 8110954
DOI: 10.1093/clinids/17.6.968 -
Pediatric Pulmonology. Supplement 1997
Review
Topics: Child, Preschool; Humans; Infant; Mass Screening; Sensitivity and Specificity; Skin Tests; Tuberculin Test; Tuberculosis
PubMed: 9443253
DOI: 10.1002/ppul.1950230885 -
Paediatric Respiratory Reviews 2004The tuberculin skin test, originally developed by Koch over a century ago as a means to treat tuberculosis, has emerged as the definitive means to identify infection... (Review)
Review
The tuberculin skin test, originally developed by Koch over a century ago as a means to treat tuberculosis, has emerged as the definitive means to identify infection with Mycobacterium tuberculosis. Its value was first demonstrated in studies of student nurses in Norway where it correctly identified uninfected students at greatest risk of dying of tuberculosis during the course of their training. The test was used to investigate contacts of active cases of tuberculosis, especially children. Cohort studies of such children undertaken in the 1950s and early 1960s showed that those who developed an induration in response to the tuberculin test of 10mm or greater were most likely to go on to develop tuberculosis in the future and that, if they were treated with isoniazid for a prolonged period (with maximal effect after 12 months of treatment), they were substantially less likely to develop tuberculosis. Since that time, the tuberculin skin test has been used extensively to identify individuals who have been infected with Mycobacterium tuberculosis and who would most likely benefit from treatment of latent tuberculous infection. Subsequently, international experts recommend that all children under five years of age who are in contact especially with sputum smear positive cases of tuberculosis should all be tested with tuberculin if it is available. Those found to have a significant reaction should be treated with isoniazid if they do not have active tuberculosis. Moreover, the tuberculin skin test has been used as a reliable means to monitor the progress of tuberculosis in the community through the means of surveys of school children to determine prevalence (and estimate incidence) of tuberculous infection in the community. The tuberculin skin test is not easy to administer or to interpret and requires careful application and interpretation. Tuberculin consists of a mixture of material produced by Mycobacterium tuberculosis as it is growing. It is prepared in a form termed 'purified protein derivative (PPD)' but is neither pure nor consists entirely of protein. Reference material has been developed to standardise it. The reading of the result of tuberculin testing requires experience and care. Inexperience leads to error (terminal digit preference). Tuberculin also detects the presence of antigens from other Mycobacteria species the most important of which is environmental Mycobacteria. Previous vaccination with BCG has less effect on the results of the test. The tuberculin test is useful to detect infection in children.
Topics: Child; Humans; Tuberculin Test; Tuberculosis, Pulmonary
PubMed: 14980258
DOI: 10.1016/s1526-0542(04)90025-5 -
Journal of Ayub Medical College,... 2018Childhood Tuberculosis remains one of the major public health concerns in developing countries like Pakistan and is responsible for high rates of morbidity and mortality...
BACKGROUND
Childhood Tuberculosis remains one of the major public health concerns in developing countries like Pakistan and is responsible for high rates of morbidity and mortality in children. Although tuberculin skin test is very commonly used by physicians all over the world, its interpretation always remains difficult and challenging. The objective of this study was to determine the frequency of positive tuberculin skin test in vaccinated and unvaccinated children suffering from tuberculosis.
METHODS
This Cross-sectional study was conducted in the department of Paediatric Ayub Teaching Hospital, Abbottabad from 1st February 2015 to 30th April 2016. A total of 150 patients were observed in this study. Children of either gender who were aged 1-15 years admitted in ward with tuberculosis were included in the study by using nonprobability convenient sampling technique. We injected 0.1 ml (10 units) of tuberculin purified protein derivative (PPD) into the anterior surface of the forearm and induration was read at 72 hours after administration. Data was entered and analysed using SPSS version 10.
RESULTS
Out of 150 children, 84 (56%) were males and 66 (44%) were females. The mean age was 7.8±3.84 years. Of these 75 (50%) were vaccinated and 75 (50%) were unvaccinated. In vaccinated Group 5.3% children had positive tuberculin skin test while in unvaccinated Group 2.7% children had positive tuberculin skin test and this difference was found statistically insignificant (pvalue= 0.40). Pulmonary TB was the diagnosis in 67 (44.7%), TBM in 65 (43.3%), abdominal TB in 7 (4.7%), disseminated TB in 4 (2.7%) and military TB in 7 (4.7%) patients.
CONCLUSIONS
The positivity of tuberculin skin test in vaccinated and unvaccinated children suffering from tuberculosis was found to be insignificant in our study. We conclude that Tuberculin Skin Test should not be used as a sole diagnostic tool for diagnosing the disease in children of our region..
Topics: Adolescent; Child; Child, Preschool; Cross-Sectional Studies; Female; Humans; Infant; Male; Pakistan; Tuberculin; Tuberculin Test; Tuberculosis; Tuberculosis Vaccines; Vaccination
PubMed: 30632330
DOI: No ID Found -
The Medical Journal of Australia Sep 1970
Topics: Australia; Humans; Public Health; Tuberculin Test
PubMed: 5477383
DOI: 10.5694/j.1326-5377.1970.tb50158.x -
Disease-a-month : DM 2006
Review
Topics: Humans; Tuberculin Test; Tuberculosis
PubMed: 17157618
DOI: 10.1016/j.disamonth.2006.09.010 -
Drug Delivery and Translational Research Aug 2019The tuberculin skin test (TST) is a long-established screening method for tuberculosis. However, the Mantoux technique is often difficult to reliably perform, which...
BACKGROUND
The tuberculin skin test (TST) is a long-established screening method for tuberculosis. However, the Mantoux technique is often difficult to reliably perform, which affects testing results and safety, which causes local skin pain and pruritus.
METHODS
In this study, dissolving microneedle-array patches (MNP) were used to deliver purified protein derivative (PPD) tuberculin into the skin. The skin reaction was compared between MNP delivery and conventional injection.
RESULTS
The MNP penetrated the skin easily with a thumb press, and the microneedle dissolved into the skin completely after 1 h. The storage life of MNP loaded with PPD (MNP-PPD) was 7 weeks at atmospheric pressure and room temperature. Only 1/50 dosage of PPD (approximately 0.04 IU) was needed in MNP compared with conventional injection (2 IU) in terms of skin reactivity to TST. When TST was tested in volunteers, the redness and induration of the skin were 19.7 ± 5.6 mm in TB patients, 12.6 ± 4.4 mm in LTBI (latent TB infection) patients, and 5.8 ± 2.7 mm in BCG vaccination healthy volunteers and lasted approximately 26 ± 5.4 days. When applied with MNP-PPD, the redness and induration on the skin decreased significantly to 3.1 ± 0.7 mm in TB patients and 2.0 ± 0.5 mm in LTBI, and the duration time was only 8.5 ± 1.5 days. Moreover, despite the relatively mild skin reactivity in BCG vaccination healthy volunteers with conventional injection, there was no skin reactivity in BCG vaccination healthy volunteers with MNP-PPD.
CONCLUSION
In addition to being minimally invasive, needle-free, and painless, no adverse effects were attributed to the new diagnostic method, which may be of value for the safe and effective clinical administration of TB screening. When applied with MNP-PPD, an area of redness and induration greater than 2.5 mm can identify a TB-positive patient.
Topics: Adolescent; Adult; BCG Vaccine; Female; Healthy Volunteers; Humans; Male; Microinjections; Middle Aged; Needles; Skin; Solubility; Transdermal Patch; Tuberculin; Tuberculin Test; Tuberculosis; Young Adult
PubMed: 30891708
DOI: 10.1007/s13346-019-00629-y -
Lab Animal Aug 2016
Topics: Abdomen; Animals; Eyelids; Haplorhini; Mycobacterium bovis; Mycobacterium tuberculosis; Thorax; Tuberculin Test; Tuberculosis, Pulmonary
PubMed: 27551802
DOI: 10.1038/laban.1086