Indian Pediatrics 2001; 38: 933  

Standardization of Mantoux Test

Mantoux test is widely used for diagnosis of tuberculosis. However, the recommendations for the inoculated dose of purified protein derivative and the extent of induration to be read as a positive test are variable.

The dose of tuberculin purified protein derivative recommended varies as 2(1), 5(2) and 10 tuberculin units(3). The size of induration to be taken as positive also differs; the monograph on guidelines for management of Acute Respiratory Infections in children(1) and information provided with Mantoux reagent(3); recommend that induration of 10 mm and more should be taken as positive but there is no mention about correlating the size of induration with epidemiologic risk factors. The Nelson Text Book of pediatrics recommends an induration of 5, 10 and 15 mm (between 48 to 72 hours after injection), to be taken as positive in presence of highest risk, high risk and low risk epidemiologic factors, respectively(2). These differences in dose of Mantoux reagent and size of induration indicative of positive test need consideration for standardization of practice.

A.K. Rawat,
Associate Professor,
Department of Pediatrics,
G.R. Medical College,
Gwalior, Madhya Pradesh, India.

References

1. Bhan MK, Bahl R, Bhandari N. Guidelines for Management of Acute Respiratory Infections in Children. Ministry of Health and Family Welfare, Government of India. 2000; p 41.

2. Starke JR, Munoz F. Tuberculosis. In: Nelson Text Book of Pediatrics, 16th edn. Behrman RE, Kliegman RM, Jenson HB, Philadelphia, W.B. Saunders Company, 2000; pp 887-888.

3. Cadilla Health Care Limited, Zydus Pathline Division, Ahmedabad. Product information provided with Mantoux Regent; 2000; p 1.