Tuberculin sensitivity

A prospective study of tuberculin sensitivity has been conducted among 3610 subjects under 20 years old in the Solomon Islands, Western Province. Mantoux positivity (greater than or equal to mm induration after 5 TU) fell from 81% during the 6 months following birth BCG vaccination to 13% for children aged 1-8 years of age among whom it was not significantly higher than the rate of 9% noted for unvaccinated subjects. Birth BCG does not, therefore, hinder the diagnostic usefulness of tuberculin testing for such children. For the study population as a whole, BCG-induced Mantoux positivity was restricted to induration under 15 mm diameter. Stronger responses were considered specific for tuberculin infection and indicated a prevalence rate that rose from 2% to 16% with age. Accelerated BCG reactions recorded among 45% of 162 tuberculin non-reactors under 8 years old indicated that the waning of tuberculin responsiveness at this time could not be equated with loss of clinical protection against tuberculosis.