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Tuberculin Skin Test, chest radiography and contact screening in children ≤5 y: relevance in Revised National Tuberculosis Control Programme (RNTCP).

AbstractOBJECTIVES:
To ascertain the status of Tuberculin Skin Test (TST) in the children aged 0-5 y who are household contacts of adults having sputum smear positive pulmonary tuberculosis and also to study the relationship of TST and Chest X-Ray (CXR) and their relevance in contact screening under RNTCP setup.
METHODS:
This prospective hospital based clinical study was conducted at a tertiary level referral medical college in Northern India. Study subjects were 200 children ≤5 y of age who were household contacts of adults with sputum smear positive pulmonary tuberculosis. All these adult index cases were registered and taking regular treatment at RNTCP centre attached to a medical college. Demographic data collection, detailed clinical history along with clinical examination, growth assessment, TST and chest radiography (CXR) was done for every child.
RESULTS:
TST was positive in 39 % children and out of these 68 % of child contacts had CXR findings suggestive of tuberculosis. This correlation was found to be highly significant (p < 0.001), especially in children less than 1 y of age. A high percentage of clinically asymptomatic children also had positive TST and CXR consistent with definition of TB disease.
CONCLUSIONS:
Contact screening must be prioritized in RNTCP. Unlike presently, TST and CXR should be actively employed in RNTCP for contact screening.
AuthorsSandhya Chauhan, Pratik Gahalaut, A K Rathi
JournalIndian journal of pediatrics (Indian J Pediatr) Vol. 80 Issue 4 Pg. 276-80 (Apr 2013) ISSN: 0973-7693 [Electronic] India
PMID22688652 (Publication Type: Comparative Study, Journal Article)
Topics
  • Adult
  • Child, Preschool
  • Contact Tracing (statistics & numerical data)
  • Female
  • Hospitals, Teaching
  • Humans
  • Incidence
  • India (epidemiology)
  • Infant
  • Infant, Newborn
  • Male
  • Malnutrition (complications)
  • Mass Screening (methods)
  • National Health Programs (statistics & numerical data)
  • Prospective Studies
  • Risk Factors
  • Tomography, X-Ray Computed
  • Tuberculin Test (methods)
  • Tuberculosis, Pulmonary (diagnosis, diagnostic imaging, epidemiology, immunology, prevention & control)

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