COMPARISON OF POSITIVITY OF TUBERCULIN SKIN TEST WITH DIAGNOSTIC BCG IN CHILDREN SUFFERING FROM TUBERCULOSIS
AbstractBackground: Tuberculosis is major public health problem in Pakistan and it is often unrecognized cause of morbidity and mortality in children living in endemic areas. Children with age less than 5 years, and especially those who are immune compromised, are at higher risk of developing tuberculosis following exposure. Tuberculosis in children is usually difficult to diagnose compare to adult patients due to its atypical presentation. Tuberculin skin test and Bacille Calmette–Guerin (BCG) are widely used as diagnostic tests for tuberculosis. It was a Cross sectional study carried out from May 2017 to Nov 2018 in the department of Paediatrics, Ayub Teaching Hospital Abbottabad. Methods: Both BCG and tuberculin skin test were performed at the same time by the same doctor. Personal data like age, gender and address, type of tuberculosis, positivity of tuberculin skin test and positivity of diagnostic BCG were recorded. The induration was read 48-72 hours after administration. Results: As per frequencies and percentages for positivity of tuberculin skin, 51 (67.10%) patients showed positivity for tuberculin skin while 71 (93.42%) patients showed positive results via BCG Test. Conclusion: In paediatric age group, diagnostic BCG test has got better diagnostic value over Tuberculin Skin Test in diagnosis of tuberculosis.Keywords: Tuberculin Skin Test; BCG Test; Pulmonary Tuberculosis
National Guidelines for the Control of Tuberculosis in Pakistan. 2015. [internet]. [cited 2019 May 27]. Available from: http://ntp.gov.pk/uploads/NATIONAL_GUIDELINE_ON_TB_CASE_MANAGEMENT_REV_JAN_2015.pdf
Direct Relief. Treating and Controlling Tuberculosis in Pakistan. [Internet]. [cited 2019 May 27]. Available from: https://www.directrelief.org/2013/03/treating-controlling-tuberculosis-pakistan/
Marais BJ, Tuberculosis in Children. J Paediatr Child Health 2014;50(10):759–67.
O’Grady J, Maeurer M, Mwaba P, kapata N, Bates M, Hoelscher M, et al. New and improved diagnostics for detection of drug-resistent pulmonary TB. Curr Opin Pulm Med 2011;17(3):134–41.
López Ávalos GG, Prado Montes de Oca E. Classic and New Diagnostic Approaches to Childhood Tuberculosis. J Trop Med 2012;2012:818219.
Sia IG, Wieland ML. Current concepts in the management of tuberculosis. Mayo Clin Proc 2011;86(4):348–61.
Nayak S, Acharjya B. Mantoux test and its interpretation. Indian Darmatol Online J 2012;3(1):2–6.
Shah I. Interpretation of Tuberculin Skin Testing in Children vaccinated with BCG. Pediatr Oncall 2012;9(10):91–2.
Mobin-ur-Rehman, Khan GS, Khan SA. Comparison of Diagnostic BCG and Mantoux Tests in the Early Detection of Tuberculosis in Children. Pak J Med Health Sci 2012;6(1):184–6.
Zulqarnain A, Iqbal I, Haq MA. Immune Response of Tuberculin test and Diagnostic BCG Test in Children Suffering from Tuberculosis [Internet]. Medical Forum 2014 [cited 2019 May 27]. Available from: http://www.medforum.pk/index.php/article-database/9-articles/26-immune-response-of-tuberculin-test-and-diagnostic-bcg-test-in-children-suffering-from-tuberculosis
Rabia M, Shabbir A, Mehmood I, Naeemullah S. Comparison of mountoux test with diagnostic BCG in paediatric patients with tuberculosis. J Rawal Med Coll 2011;15(1):18–20.
Slogotskaya L, Bogorodskaya E, Ivanova D, Sevostyanova T. Comparative sensitivity of the test with tuberculosis recombinant allergen, containing ESAT6-CFP10 protein, and Mantoux test with 2TU PP-L in newly diagnosed tuberculosis children and adolescent in Mosco. PLoS One 2018;13(12):e0208705.
Mueller-Hermelink M, Kobbe R, Methling B, Rau C, Schulze-Sturm U, Auer I, et al. Universal screening for latent and active tuberculosis (TB) in asylum seeking children, Bochum and Hamburg, Germany, September 2015 to November 2016. Euro Surveil 2018;23(12).
Veasco-Amaiz E, Soriano-arandes A, Latorre N, Altet N, Dominguez J, Fortuny C, et al. Performance of tuberculin skin tests and interferon- γ release assays in children younger than 5 years. Pediatr Infect Dis J 2018;37(12):1235–41.
Anis-ur-Rehman, Idris M. Comparison of Mantoux’s test with diagnostic BCG in pediatric parients with pulmonary tuberculosis. J Ayub Med Coll Abbottabad 2005;17(2):6–8.
Göçrnen A, Kiper N, Ertan Ü, Kalayci Ö, Özçelik U. Is BCG test of diagnostic value in tuberculosis? Tuber Luung Dis 1994;75(1):54–7.
Reyes CM, Sanchez L, Ong-Lim AL, Gonzales LM. A paired comparison of tuberculin skin test results in children with clinical manifestations of tuberculosis using 2 TU and 5 TU tuberculin. PIDSP J. 2011;12(2):56–66.
Udani PM. Tuberculosis in children. Pediatr Clin India 2010;18:143–56.
Iqbal MJ, Sarfraz M. Comparison of diagnostic BCG test with Mantoux in children with suspicion of Tuberculosis. King Edw Med Univ 2003;9(1):23–7.
Chiappini E, Storelli F, Tersigni C, Venturini E, de Martino M, Galli L. QuantiFERON-TB Gold in Tube test performance in a large pediatric population investigated for suspected tuberculosis infection. Pediatr Resir Rev 201932:36–47.
Beguin T, Khattak AA, Khan FM. Tuberculosis: a major threat to child health. Pak Pediatr J 2012;3:28–30.
Usman M, Aleem A, Raza H. Frequency of positive results of Bacille Calmette Gurein and Mantoux skin tests in suspected cases of childhood pulmonary tuberculosis. Ann King Adward Med Univ 2016;22(4):257–63.
Anjum R, Qayum Sm Rashid A. Evaluation of BCG test in diagnosis of tuberculosis in BCG vaccinated children and its comparison with Mantoux test. Int J Contemp Pediatr 2016;3(4):1339–43.
Kabra SK, Lodha R, Seth V. Some current concepts on childhood tuberculosis. Indian J Med Res 2004;120(4):387–97.
Loeffler AM. Pediatric tuberculosis. Semin Respir Infect 2003;18(4):272–91.
Barenholz A, Hovav AH, Fishman Y, Rahav G, Gershoni JM, Bercovier H. A peptide mimetic of the mycobacterial mannosylatedlipoarabinomannan: characterization and potential applications. J Med Microbiol 2007;56(Pt 5):579–86.