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Need for Different Cutoff Values for Reading Mantoux Test with 2TU and 5TU PPD
Savitha M Ramaraj1, K Nagendra2, Girish Gopal2
1Department of Pediatrics, Mysore Medical College and Research Institute, Cheluvamba Hospital, Irwin Road, Mysore, Karnataka, 570001, India. drsavithamr@yahoo.com.
Indian Journal of Pediatrics
|May 26, 2017
Summary
The 2 tuberculin unit (TU) and 5TU purified protein derivative (PPD) tests showed no agreement in diagnosing tuberculosis in children. Results indicate that 2TU PPD is not comparable to 5TU PPD for assessing cutaneous hypersensitivity.
Area of Science:
- Pediatrics
- Immunology
- Infectious Diseases
Background:
- Tuberculin skin testing is crucial for tuberculosis diagnosis.
- Standardized purified protein derivative (PPD) dosages are essential for reliable results.
- Comparing different PPD strengths is vital for accurate clinical interpretation.
Purpose of the Study:
- To compare the efficacy of 2 tuberculin unit (TU) versus 5TU purified protein derivative (PPD) in eliciting tuberculin reactions in healthy children.
- To assess the agreement between 2TU PPD and 5TU PPD in identifying latent tuberculosis infection.
Main Methods:
- A cross-sectional study involving 70 healthy children aged 1-12 years.
- Simultaneous Mantoux testing with 2TU and 5TU PPD, with reactions read at 48-72 hours.
- Statistical analysis using McNemar's test, Wilcoxon test, Bland-Altman plots, and kappa statistic to evaluate agreement.
Main Results:
- Only 1 child (10%) tested positive with 2TU PPD, while 7 children (10%) tested positive with 5TU PPD (p=0.031).
- Significant differences in mean induration diameter between 2TU and 5TU PPD (p<0.001).
- No agreement was found between the two PPD strengths based on Bland-Altman plots and kappa statistics.
Conclusions:
- Cutaneous hypersensitivity responses to 2TU PPD and 5TU PPD are not comparable in healthy children.
- The findings suggest potential discrepancies in tuberculosis screening when using different PPD concentrations.
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