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Tuberculin test in children with malnutrition

British Medical Journal
|August 31, 1968
PubMed

Insights

Tuberculin sensitivity is impaired in malnourished children. Higher doses of tuberculin, particularly with intradermal tests, are more effective for diagnosing tuberculosis in this population.

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Immunology

Background:

  • Severe malnutrition can significantly impact immune function.
  • Tuberculin sensitivity, a key indicator for tuberculosis diagnosis, may be compromised in malnourished individuals.
  • Accurate tuberculosis diagnosis is crucial for effective treatment and public health.

Purpose of the Study:

  • To evaluate tuberculin test sensitivity in children with severe malnutrition.
  • To compare the efficacy of different tuberculin testing methods and strengths in this population.
  • To determine optimal diagnostic approaches for tuberculosis in malnourished children.

Main Methods:

  • Conducted Heaf's multiple-puncture tuberculin tests and intradermal tests with varying strengths of old tuberculin on 402 severely malnourished children.
  • Diagnosed active tuberculosis based on radiological and bacteriological findings.
  • Assessed tuberculin test positivity rates in children with confirmed active tuberculosis.

Main Results:

  • 51 children (12.5%) were diagnosed with active tuberculosis.
  • The Heaf test showed low positivity (11 children).
  • Intradermal testing with 100 tuberculin units yielded a higher positive response (an additional 18 children).

Conclusions:

  • Tuberculin sensitivity is demonstrably impaired in children with severe malnutrition.
  • Higher doses of tuberculin, especially via intradermal administration, are more likely to detect tuberculosis in this vulnerable group.
  • Revised tuberculin testing strategies may be necessary for accurate tuberculosis diagnosis in malnourished children.

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