Sandhya Chauhan1, Pratik Gahalaut, A K Rathi. 1. Department of Pediatrics, Sri Ram Murti Smarak Institute of Medical Sciences, Bareilly, Uttar Pradesh, India. drsandhyapedia@gmail.com
Abstract
OBJECTIVES: To ascertain the status of Tuberculin Skin Test (TST) in the children aged 0-5 y who are household contacts of adults having sputum smear positive pulmonary tuberculosis and also to study the relationship of TST and Chest X-Ray (CXR) and their relevance in contact screening under RNTCP setup. METHODS: This prospective hospital based clinical study was conducted at a tertiary level referral medical college in Northern India. Study subjects were 200 children ≤5 y of age who were household contacts of adults with sputum smear positive pulmonary tuberculosis. All these adult index cases were registered and taking regular treatment at RNTCP centre attached to a medical college. Demographic data collection, detailed clinical history along with clinical examination, growth assessment, TST and chest radiography (CXR) was done for every child. RESULTS: TST was positive in 39 % children and out of these 68 % of child contacts had CXR findings suggestive of tuberculosis. This correlation was found to be highly significant (p < 0.001), especially in children less than 1 y of age. A high percentage of clinically asymptomatic children also had positive TST and CXR consistent with definition of TB disease. CONCLUSIONS: Contact screening must be prioritized in RNTCP. Unlike presently, TST and CXR should be actively employed in RNTCP for contact screening.
OBJECTIVES: To ascertain the status of Tuberculin Skin Test (TST) in the children aged 0-5 y who are household contacts of adults having sputum smear positive pulmonary tuberculosis and also to study the relationship of TST and Chest X-Ray (CXR) and their relevance in contact screening under RNTCP setup. METHODS: This prospective hospital based clinical study was conducted at a tertiary level referral medical college in Northern India. Study subjects were 200 children ≤5 y of age who were household contacts of adults with sputum smear positive pulmonary tuberculosis. All these adult index cases were registered and taking regular treatment at RNTCP centre attached to a medical college. Demographic data collection, detailed clinical history along with clinical examination, growth assessment, TST and chest radiography (CXR) was done for every child. RESULTS: TST was positive in 39 % children and out of these 68 % of child contacts had CXR findings suggestive of tuberculosis. This correlation was found to be highly significant (p < 0.001), especially in children less than 1 y of age. A high percentage of clinically asymptomatic children also had positive TST and CXR consistent with definition of TB disease. CONCLUSIONS: Contact screening must be prioritized in RNTCP. Unlike presently, TST and CXR should be actively employed in RNTCP for contact screening.
Authors: B J Marais; R P Gie; H S Schaaf; A C Hesseling; C C Obihara; J J Starke; D A Enarson; P R Donald; N Beyers Journal: Int J Tuberc Lung Dis Date: 2004-04 Impact factor: 2.373