The reaction to the Mantoux test in a child

The Mantoux test should not be confused with vaccinations, since this is not a vaccination, but a special skin test, the results of which help to reveal infection with tuberculosis. What else should parents know about this test and how to act with a positive Mantoux reaction?

The essence of this test is the introduction of child tuberculin - a drug made from mycobacterial tuberculosis. At the injection site, a local reaction begins, according to which they evaluate whether the organism is familiar with tubercle bacilli or not.

Thanks to the Mantoux test, you can:

• Early detection of tuberculosis in children.
• Determine whether vaccination is needed, as well as revaccination against tuberculosis.

The effectiveness of the test is not always reliable, as it is influenced by the characteristics of storage and transportation of tuberculin, errors in the injection or counting, the presence of allergic and chronic diseases, skin sensitivity, air humidity, the use of medicines and other factors. Also, the test can cause allergies, fever, loss of appetite, weakness, skin rash.

The famous pediatrician considers the Mantoux test as an important diagnostic test that every child should carry out. He is confident that with such a prevalence of tuberculosis, which is celebrated in our day, it is not safe to refuse Mantu.

For more on this, see Dr. Komarovsky’s program.

Tuberculin in a dose of two units (0.1 ml of solution) is administered intracutaneously to children in the arm in the middle of the forearm area. The first test is carried out at 12 months and is repeated every year (usually in the autumn time). Hand during the next test change.

Sample results are evaluated on the third day - after 72 hours. In the state. Institutions often do the sample on Friday, and the result is estimated on Monday.

First of all, two variants of the reaction are taken into account:

• The appearance of hyperemia (the injection site turns red).
• The appearance of the papule (the injection site becomes dense and rounded).

The reaction may be:

1. Negative. No changes on the skin of the child is detected.
2. Doubtful. A papule from 2 to 4 mm has appeared, or there is no papule, but there is a hyperemia of any size.
3. Positive. Such a reaction, depending on the diameter of the papule that appeared, is considered mild (5-9 mm), medium-intensity (10-14 mm) and pronounced (15-16 mm).
4. Excessive. If the diameter of the papule formed is more than 17 mm or a reaction of the lymph nodes is noted, papule ulceration and other signs of inflammation have appeared. This reaction is also called hyperergic.

Upon receipt of a dubious result, a child can be sent for blood and urine tests, and parents can undergo FG examinations. After registration on the "turn" (the results of the sample are taken into account in the dynamics - the current year compared to the previous result), the TB doctor may order a chest X-ray and Diaskintest.

On the basis of the joint venture 3.1.2.3114-13 "Prevention of tuberculosis" dated 22.10.2013 Children who have not submitted a phthisiatric tuberculosis conclusion are not allowed into children's organizations. Such an opinion must be provided within 1 month from the moment the child was given a Mantoux test.

You can wash the baby after the Mantoux test, but you should not scratch and rub the injection site. It is also prohibited to glue the adhesive tape in place, smear it with any disinfecting solution or bandage.

Tips not to swim after Mantoux began to be given at the time of not skin tests, but skin tests. In the past 15 years, all Mantoux tests are carried out with the use of intradermal administration of tuberculin, and water does not enter the skin during bathing.

If the test result is negative, it means that the child’s body did not encounter mycobacterium tuberculosis and did not get sick, but did not develop immunity to them.

A questionable result is equated to a negative one or, if necessary, additional examinations are prescribed.

But a positive reaction may indicate both the presence of immunity and infection.

At the same time, only Mantoux cannot be diagnosed; therefore, if a child is infected with tuberculosis, it is necessary to examine him further. First, a sample will be performed again at the tuberculosis dispensary, and then they will conduct an examination and prescribe additional tests.

Many parents mistakenly include the Mantoux test for vaccinations, so quite often they want to refuse it.

However, if parents are confident that they want to give up Mantoux for their children, they have such a right. Refusal to make out in writing according to the sample, which is issued in the clinic. However, they must understand all the risks of such a failure.

There is a method that, like Mantoux, determines the presence of a tuberculosis disease. He is called Diaskintest.The test is also carried out intracutaneously and its results are measured, and the reaction to this test will be only if there are active mycobacteria in the body, as it contains mycobacterial proteins that cause tuberculosis in humans and does not contain the proteins of the mycobacterial vaccine strain introduced to the child during BCG vaccination .

But, since Diaskintest will not show whether there is immunity to tuberculosis, they should not replace the Mantoux test, but it is worth using this test only as a supplement that helps confirm the progression of the disease. Such a test will not help to determine whether the BCG is still active or a child at the age of 7 needs a new vaccination. In addition, about 5-8% of children become infected with bovine-type mycobacteria, to which Diaskintest does not respond.

• You should not give antihistamines to your child before the test, because they can affect the assessment of results.
• Limit in the child's menu foods that may cause an allergic reaction, such as chocolate and citrus.

You can learn more about the Mantoux reaction in the following videos.