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Is tuberculin testing before BCG vaccination necessary for children over three months of age?

B Hennessy1

  • 1Department of Community Health, Western Road, Clonmel, Co Tipperary. Brendan.Hennessy@hse.ie

Irish Medical Journal
|June 11, 2008
PubMed

Insights

Tuberculin (Mantoux) skin testing before BCG vaccination in children yields few positive results. This low yield suggests the test is not valuable for detecting tuberculosis in young children.

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Public Health

Background:

  • Irish national policy changed in July 2007 regarding tuberculin skin testing before BCG vaccination for children.
  • Previously, tuberculin (Mantoux) skin testing was mandatory for children aged 3 months to 6 years before BCG vaccination.

Purpose of the Study:

  • To assess the diagnostic value of pre-BCG tuberculin skin testing in children.
  • To evaluate the yield of positive tuberculin test results in the context of BCG vaccination protocols.

Main Methods:

  • A retrospective study was conducted on 1,854 tuberculin tests performed prior to BCG vaccination.
  • Analysis focused on the percentage of positive test results (induration > 5mm) in different age groups.

Main Results:

  • Only 0.7% of all tested children showed a positive tuberculin skin test result.
  • No children under 6 years of age tested positive; children over 12 were more likely to test positive (1.09% vs 0.4%).

Conclusions:

  • Pre-vaccination tuberculin skin testing in young children has a low yield for detecting tuberculosis.
  • The study suggests that routine tuberculin testing before BCG vaccination offers limited value in identifying latent or active TB in this population.

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