Tuberculine test in infants and children who have contact to sputum positive adult pulmonary tuberculosis patients

Khainir Akbar; Ridwan M. Daulay; Helmi Lubis; Zakaria Siregar; Gabriel Panggabean; Nuraida Nuraida

doi:10.14238/pi39.7-8.1999.221-8

Khainir Akbar Department of Child Health, University of Sumatera Utara/H. Adam Malik Hospital, Medan, North Sumatera
Ridwan M. Daulay Department of Child Health, University of Sumatera Utara/H. Adam Malik Hospital, Medan, North Sumatera
Helmi Lubis Department of Child Health, University of Sumatera Utara/H. Adam Malik Hospital, Medan, North Sumatera
Zakaria Siregar Department of Child Health, University of Sumatera Utara/H. Adam Malik Hospital, Medan, North Sumatera
Gabriel Panggabean Department of Child Health, University of Sumatera Utara/H. Adam Malik Hospital, Medan, North Sumatera
Nuraida Nuraida Department of Child Health, University of Sumatera Utara/H. Adam Malik Hospital, Medan, North Sumatera

DOI: https://doi.org/10.14238/pi39.7-8.1999.221-8

Keywords: tuberculine test, sputum positive, acid fast bacilli, Mantoux

Abstract

This study aimed to determine the pattern of pulmonary tuberculosis
infection in infants and children who had household contact to adtult tuberculosis patients with sputum positive for acid-fast bacilli (AFB). Tuberculine (Mantoux) test was performed in 270 such infants or children. The results showed that tuberculine test positivity in household contact group of adult tuberculosis patients with positive AFB sputum were significantly different from patients with negative AFB sputum for the age groups 0-18, 0-14, 0-4, 5-9, 10-14 years but not for 15-18 age group. There were no significant difference in positivity of tuberculine test result according to gender or BCG vaccination status, but there was significant difference between children who slept in the same bed room with the source case and those who did not. Semi-quantitative bacteriological status of the sputum (AFB +, or++ or+++) did not affect positivity of tuberculine test result. We conclude that infants and children with household contact to sputum positive adult pulmonary tubercula is patients are at high risk for developing tuberculosis infection particularly those who sleep in the same
bed room with the source case.

References

1. Sherris JD, Blackburn R. Immunizing the world's children. In: Population reports. Seri 1:5. April1986:L164-6.
2. Cheng TL, Miller EB, Ottolini M, Srasseux C, Rosenquist G. Tuberculosis testing. Physicians attitudes and practice. Arch Pediatr Adolesc Med 1996; 150: 682~5.
3. Hassan R, Alatas H. Tuberkulosis pada anak. In: Buku Kuliah IKA FKUI; 2nd ed. Jakarta: FKUI 1985; 573-84.
4. Suraatmaja S. Perkembangan mutakhir dari imunisasi. Medika 1987; 4:389-98.
5. Rahajoe NN. Berbagai masalah diagnostik dan tatalaksana tuberkulosis anak. In: Rahajoe N, Rahajoe NN, Boediman I, Said M, Supriyatno B. Perkembangan masalah pulmonologi anak saat ini. Jakarta FKUI, 1994;161-79.
6. Abednego HM. Kebijaksanaan baru dalam penanggulangan tuberkulosis di Indonesia. Disarnpaikan pada Kongres VI perhimpunan pemberantasan tuberkulosis Indonesia (PPTI). Ciloto. November 1996.
7. Inselman LS, Kendig Jr. Tuberculosis. In: Chernick V, Kendig EL. Kendig's disorder of the respiratory tract in children; 5th ed. Philadelphia: WB Saunders Co 1990; 730-42.
8. Speck WT. Tuberculosis. In: Behrman RE, Kliegrnan RM, Nelson WE, Vaughan III VC. Nelson's textbook of pediatrics; 14th ed. Philadelphia: WB Saunders Co 1992; 763-4.
9. WHO. Childhood tuberculosis and BCG vaccine. BCG-gateway to EPI. Expanded programme on immunization. Agustus 1989.
10. Gunnels JJ, Bates JH, Swindall H. Infectivity of sputum positive tuberculosis patients on chemotheraphy. Am Rev Respir Dis 1974; 109:323-30.
11. Speert DP. 1'uberculosis. In: Krugman S, Katz SL, Gershon M, Wilfert CM. Infectious disease of children, 9th ed. Philadelphia: Mosby year book 1992;551-71.
12. Trastotenojo MS, Hendarto T, Zain S. Diagnosis tuberkulosis paru pada anak. Majalah Dokter Keluarga 1985; 4:223-9.
13. Rahajoe NN. Problematik klinik tuberkulosis anak. Maj Kedok Indon 1981; 31:118-22.
14. Johnson RF, Wildrich KH. State of art review. The impact of chemoteraphy on the care of patients with tuberculosis. Am Rev Res Pir Dis 1974; 109:636-63.
15. Narain R, Rao MSS, Chandrasekhar P & Pyarelal. Microscopy positive and microscopy negative cases of pulmonary tuberculosis. Am Rev Respir Dis 1970; 103:761-3.
16. Iseman MD, Bentz RR, Fraser RI, Locks MO, Ostrow JH, Sewell EM. Guidelines for investigation and management of tuberculosis contacts. Am Thorac Soc 1976; 14:459-63.
17. WHO. WHO statement on BCG revaccination for the prevention of tuberculosis. Bulletin ofWHO OMS 1995; 73:805-6.
18. Putrali J, Sutrisna B, Rahajoe N, Gunardi SS, Gunowiseso. Penelitian effektivitas vaksinasi BCG pada anak-anak di 8 RS di Jakarta. Medika 1982; 10:776-86.
19. Curtis HM, Leek I & Bamford FN: Incidence of childhood tuberculosis after neonatal BCG vaccination. The Lancet 1981 ; 21 : 146-8.
20. Al Kassimi FA, Al H~aj MS, Al Oraney IO, Bamboye EA. Does the protective effect of neonatal BCG correlate with vaccine-induced tuberculin reaction? Am J Respir Crit Care Med 1995; 152:1575-8.
21. Karonga Prevention Trial Group. Randomised controlled trial of single BCG, repeatec BCG or combined BCG and killed mycobacterium Leprae vaccine for prevention of leprosy and tuberculosis in Malawi. The Lancet 1996; 348: 17-24.
22. Siregar M, Lubis CP, Judin A, Hasyim IB, Saragih M. Survei BCG, tes Mantoux pada anak di poliklinik Mobil Oil dan Rumah Sakit Umum Lhok Seumawe. Medika 1991; 2:116-20.