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Heaf test results after neonatal BCG.

P A Crawshaw¹, A H Thomson

¹Community Child Health Department, Derby.

Archives of Disease in Childhood

|December 1, 1988

Summary

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Heaf testing is effective for tuberculosis screening in BCG-vaccinated children. A study found few strongly positive reactions, indicating its continued utility in public health surveillance.

Area of Science:

Pediatric Infectious Diseases
Immunology
Public Health

Background:

Bacille Calmette-Guérin (BCG) vaccination is widely used for tuberculosis (TB) prevention.
Evaluating the efficacy of TB screening methods in vaccinated populations is crucial.
The Heaf test is a type of tuberculin skin test used for TB screening.

Purpose of the Study:

To assess the utility of Heaf testing for tuberculosis screening in preschool Asian children previously vaccinated with BCG.
To determine the rate of positive Heaf reactions in this specific demographic.

Main Methods:

Heaf testing was performed on 98 preschool Asian children.
All participants had a history of neonatal BCG vaccination.
Reactions were graded to assess the strength of the Heaf response.

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Main Results:

Only two out of 98 children (approximately 2%) exhibited a strongly positive Heaf reaction (grade 3).
The low incidence of strong reactions suggests BCG vaccination may attenuate Heaf test responses.
The findings indicate a low prevalence of active TB or significant post-BCG sensitization detectable by Heaf test.

Conclusions:

Heaf testing remains a viable tool for tuberculosis screening in populations with BCG vaccination.
The test's utility is confirmed, even with the potential for reduced reaction strength post-vaccination.
Neonatal BCG vaccination does not preclude the effective use of Heaf testing in TB surveillance programs.