Mantoux tests of children in household contact with adult acid fast bacilli-positive  or -negative pulmonary tuberculosis

Wardah Wardah; Ridwan Muktar Daulay; Emil Azlin; Wisman Dalimunthe; Rini Savitri Daulay

doi:10.14238/pi57.6.2017.310-5

Wardah Wardah Department of Child Health, University of Sumatera Utara Medical School/H. Adam Malik Hospital, Medan, North Sumatera
Ridwan Muktar Daulay Department of Child Health, University of Sumatera Utara Medical School/H. Adam Malik Hospital, Medan, North Sumatera
Emil Azlin Department of Child Health, University of Sumatera Utara Medical School/H. Adam Malik Hospital, Medan, North Sumatera
Wisman Dalimunthe Department of Child Health, University of Sumatera Utara Medical School/H. Adam Malik Hospital, Medan, North Sumatera
Rini Savitri Daulay Department of Child Health, University of Sumatera Utara Medical School/H. Adam Malik Hospital, Medan, North Sumatera

DOI: https://doi.org/10.14238/pi57.6.2017.310-5

Keywords: tuberculosis, children, acid fast bacilli, household contact

Abstract

Background Tuberculosis (TB) is the leading cause of mortality and morbidity in developing countries. In children, the major source of TB transmission is adults with pulmonary TB who have acid fast bacilli (AFB)-positive sputum. However, tuberculosis infection can also occur in children in household contact with adults who have AFB-negative pulmonary TB.

Objective To compare Mantoux test results and induration diameters in children with adult pulmonary TB household contact who were either positive or negative for AFB, and to assess for possible associations between Mantoux test results with age, family income, and house ventilation in both groups.

Methods A cross-sectional study was conducted from January to March 2014. Mantoux test was performed in children aged 3 months to 18 years who had household contact with either AFB-positive or -negative adult pulmonary TB patients.

Results A total of 106 children were enrolled in the study. All subjects had household contact with adult pulmonary TB patients who were either AFB-positive (54 children) or AFB-negative (52 children). Mean Mantoux test induration diameters were significantly different between groups (10.9 (SD 6.55) mm vs. 6.2 (SD 5.91) mm, respectively; P=0.001). In addition, there was significantly higher risk of positive Mantoux test in children in contact with adult AFB-positive TB patients than in the AFB-negative group (OR 5.66; 95%CI 2.36-13.59; P=0.0001). However, there were no significant differences in positive Mantoux test results in each of the AFB-positive and -negative groups, with regards to age, family income, or house ventilation.

Conclusion Mean Mantoux test induration diameter in children who had household contact with AFB-positive adults is significantly larger than that of the AFB-negative group. Positive Mantoux test results in children are associated with AFB-positive adult TB in the household. There is no association between positive Mantoux test results and age, family income, or house ventilation in both groups.

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References

1. Zaman K. Tuberculosis: a global health problem. J Health Popul Nutr. 2010;28:111-3.
2. World Health Organization. Global tuberculosis report. World Health Organization. 2012.
3. Kementrian Kesehatan Republik Indonesia. Laporan situasi terkini perkembangan Tuberkulosis di Indonesia. Jakarta: Kementrian Kesehatan Republik Indonesia; 2012. p. 1-18.
4. Rahajoe NN, Basir D, Makmuri MS, Kartasasmita CB, editors. Pedoman nasional tuberkulosis anak. 2nd ed. Jakarta: UKK Respirologi PP IDAI; 2007. p. 1-37.
5. Singh M, Mynak ML, Kumar L, Mathew JL, Jindal SK. Prevalence and risk factors for transmission of infection among children in household contact with adults having pulmonary tuberculosis. Arch Dis Child. 2005;90:624-8.
6. Nakaoka H, Lawson L, Squire SB, Coulter B, Ravn P, Brock I, et al. Risk for tuberculosis among children. Emerg Infect Dis.2006;12:1383-8.
7. Iskandar H, Nataprawira HMD, Garna H, Djais JTB. Tuberculosis prevalence among underfive children in household contact with negative acid fast bacilli adult pulmonary tuberculosis. Pediatr Indones. 2008;48:18-22.
8. Alseda M, Godoy P. Tuberculin reaction size in tuberculosis patient contacts. Arch Broncopneumol. 2007;43:161-4.
9. Nguyen TH, Odermatt P, Slesak G, Barennes H. Risk of latent tuberculosis infection in children living in households with tuberculosis patients: a cross sectional survey in remote northern Lao People's Democratic Republic. BMC Infect Dis. 2009;9:96.
10. Talay F, Kumbetli S. Risk factors affecting the development of tuberculosis infection and disease in household contacts of patients with pulmonary tuberculosis. Turkish Respir J. 2008;9:34-7.
11. Walakandau LR, Umboh A, Wahanai A. The occurrence and is factors of tuberculosis in children with close contact to adult lung tuberculosis. Paediatr Indones. 2010;50:233-8.
12. Caldeira ZMR, Santâ€™anna CC, Aiden MA. Tuberculosis contact tracing among children and adolescent. Brazil Rev Saude Publica. 2004;8:1-6.
13. Batra S, Ayaz A, Murtaza A, Ahmad S, Hasan R, Pfau R. Childhood tuberculosis in household contacts of newly diagnosed TB patients. PLoS One. 2012;7:e40880.
14. Triasih R, Rutherford M, Lestari T, Utarini A, Robertson CF, Graham SM. Contact investigation of children exposed to tuberculosis in South East Asia: a systematic review. J Trop Med. 2012;2012:301808.
15. Tornee S, Kaewkungwal J, Fungladda W, Silachamroon U, Akarasewi P, Sunakorn P. The association between environmental factors and tuberculosis infection among household contacts. Southeast Asian J Trop Med Public Health. 2005;36:221-4.
16. Spence DP, Hotchkiss J, William CS, Davies PD. Tuberculosis and poverty. BMJ. 1993;307:759-61.
17. Tupasi TE, Radhakrishna S, Quelapio MID, Villa MLA, Pascual MLG, Rivera AB, et al. Tuberculosis in the urban poor settlements in the Philippines. Int J Tuberc Lung Dis. 2000;4:4-11.
18. Wong MK, Yadav RP, Nishikiori N, Eang MT. The association between household poverty rates and tuberculosis case notification rates in Cambodia, 2010. Western Pac Surveill Response J. 2013;4:25-33.
19. Rutherford ME, Hill PC, Maharani W, Apriani L, Sampurno H, van Crevel R, et al. Risk factors for Mycobacterium tuberculosis infection in Indonesian children living with a sputum smear-positive case. Int J Tuberc Lung Dis. 2012;16:1594-9.