Comparison of mantoux and tine tuberculin skin tests in BCG-vaccinated children investigated for tuberculosis

Simple item page
dc.contributor.authorPan, Wenlien_ZA
dc.contributor.authorMatizirofa, Lynessen_ZA
dc.contributor.authorWorkman, Lesleyen_ZA
dc.contributor.authorHawkridge, Tonyen_ZA
dc.contributor.authorHanekom, Willemen_ZA
dc.contributor.authorMahomed, Hassanen_ZA
dc.contributor.authorHussey, Gregoryen_ZA
dc.contributor.authorHatherill, Marken_ZA
dc.date.accessioned2016-01-11T06:52:18Z
dc.date.available2016-01-11T06:52:18Z
dc.date.issued2009en_ZA
dc.description.abstractBackground: Tuberculin skin tests (TSTs) are long-established screening methods for tuberculosis (TB). We aimed to compare agreement between the intradermal Mantoux and multipuncture percutaneous Tine methods and to quantify risk factors for a positive test result. Methodology/Principal Findings: 1512 South African children younger than 5 years of age who were investigated for tuberculosis (TB) during a Bacille Calmette Guerin (BCG) trial were included in this analysis. Children underwent both Mantoux and Tine tests. A positive test was defined as Mantoux ≥15 mm or Tine ≥ Grade 3 for the binary comparison. Agreement was evaluated using kappa (binary) and weighted kappa (hierarchical). Multivariate regression models identified independent risk factors for TST positivity. The Mantoux test was positive in 430 children (28.4%) and the Tine test in 496 children (32.8%, p<0.0001), with observed binary agreement 87.3% (kappa 0.70) and hierarchical agreement 85.0% (weighted kappa 0.66). Among 173 children culture-positive for Mycobacterium tuberculosis, Mantoux was positive in 49.1% and Tine in 54.9%, p<0.0001 (kappa 0.70). Evidence of digit preference was noted for Mantoux readings at 5 mm threshold intervals. After adjustment for confounders, a positive culture, suggestive chest radiograph, and proximity of TB contact were risk factors for a positive test using both TST methods. There were no independent associations between ethnicity, gender, age, or over-crowding, and TST result. Conclusions/Significance: The Tine test demonstrated a higher positive test rate than the Mantoux, with substantial agreement between TST methods among young BCG-vaccinated children. TB disease and exposure factors, but not demographic variables, were independent risk factors for a positive result using either test method. These findings suggest that the Tine might be a useful screening tool for childhood TB in resource-limited countries.en_ZA
dc.identifier.apacitationPan, W., Matizirofa, L., Workman, L., Hawkridge, T., Hanekom, W., Mahomed, H., ... Hatherill, M. (2009). Comparison of mantoux and tine tuberculin skin tests in BCG-vaccinated children investigated for tuberculosis. <i>PLoS One</i>, http://hdl.handle.net/11427/16264en_ZA
dc.identifier.chicagocitationPan, Wenli, Lyness Matizirofa, Lesley Workman, Tony Hawkridge, Willem Hanekom, Hassan Mahomed, Gregory Hussey, and Mark Hatherill "Comparison of mantoux and tine tuberculin skin tests in BCG-vaccinated children investigated for tuberculosis." <i>PLoS One</i> (2009) http://hdl.handle.net/11427/16264en_ZA
dc.identifier.citationPan, W., Matizirofa, L., Workman, L., Hawkridge, T., Hanekom, W., Mahomed, H., ... & Hatherill, M. (2009). Comparison of mantoux and tine tuberculin skin tests in BCG-vaccinated children investigated for tuberculosis. PloS one, 4(11), e8085. doi:10.1371/journal.pone.0008085en_ZA
dc.identifier.ris TY - Journal Article AU - Pan, Wenli AU - Matizirofa, Lyness AU - Workman, Lesley AU - Hawkridge, Tony AU - Hanekom, Willem AU - Mahomed, Hassan AU - Hussey, Gregory AU - Hatherill, Mark AB - Background: Tuberculin skin tests (TSTs) are long-established screening methods for tuberculosis (TB). We aimed to compare agreement between the intradermal Mantoux and multipuncture percutaneous Tine methods and to quantify risk factors for a positive test result. Methodology/Principal Findings: 1512 South African children younger than 5 years of age who were investigated for tuberculosis (TB) during a Bacille Calmette Guerin (BCG) trial were included in this analysis. Children underwent both Mantoux and Tine tests. A positive test was defined as Mantoux ≥15 mm or Tine ≥ Grade 3 for the binary comparison. Agreement was evaluated using kappa (binary) and weighted kappa (hierarchical). Multivariate regression models identified independent risk factors for TST positivity. The Mantoux test was positive in 430 children (28.4%) and the Tine test in 496 children (32.8%, p<0.0001), with observed binary agreement 87.3% (kappa 0.70) and hierarchical agreement 85.0% (weighted kappa 0.66). Among 173 children culture-positive for Mycobacterium tuberculosis, Mantoux was positive in 49.1% and Tine in 54.9%, p<0.0001 (kappa 0.70). Evidence of digit preference was noted for Mantoux readings at 5 mm threshold intervals. After adjustment for confounders, a positive culture, suggestive chest radiograph, and proximity of TB contact were risk factors for a positive test using both TST methods. There were no independent associations between ethnicity, gender, age, or over-crowding, and TST result. Conclusions/Significance: The Tine test demonstrated a higher positive test rate than the Mantoux, with substantial agreement between TST methods among young BCG-vaccinated children. TB disease and exposure factors, but not demographic variables, were independent risk factors for a positive result using either test method. These findings suggest that the Tine might be a useful screening tool for childhood TB in resource-limited countries. DA - 2009 DB - OpenUCT DO - 10.1371/journal.pone.0008085 DP - University of Cape Town J1 - PLoS One LK - https://open.uct.ac.za PB - University of Cape Town PY - 2009 T1 - Comparison of mantoux and tine tuberculin skin tests in BCG-vaccinated children investigated for tuberculosis TI - Comparison of mantoux and tine tuberculin skin tests in BCG-vaccinated children investigated for tuberculosis UR - http://hdl.handle.net/11427/16264 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/16264
dc.identifier.urihttp://dx.doi.org/10.1371/journal.pone.0008085
dc.identifier.vancouvercitationPan W, Matizirofa L, Workman L, Hawkridge T, Hanekom W, Mahomed H, et al. Comparison of mantoux and tine tuberculin skin tests in BCG-vaccinated children investigated for tuberculosis. PLoS One. 2009; http://hdl.handle.net/11427/16264.en_ZA
dc.language.isoengen_ZA
dc.publisherPublic Library of Scienceen_ZA
dc.publisher.departmentSouth African Tuberculosis Vaccine Initiative (SATVI)en_ZA
dc.publisher.facultyFaculty of Health Sciencesen_ZA
dc.publisher.institutionUniversity of Cape Town
dc.rightsThis is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.en_ZA
dc.rights.holder© 2009 Pan et alen_ZA
dc.rights.urihttp://creativecommons.org/licenses/by/4.0en_ZA
dc.sourcePLoS Oneen_ZA
dc.source.urihttp://journals.plos.org/plosoneen_ZA
dc.subject.otherTuberculosisen_ZA
dc.subject.otherChildrenen_ZA
dc.subject.otherMycobacterium tuberculosisen_ZA
dc.subject.otherHIV infectionsen_ZA
dc.subject.otherTuberculosis diagnosis and managementen_ZA
dc.subject.otherAdultsen_ZA
dc.subject.otherFeversen_ZA
dc.subject.otherTuberculinen_ZA
dc.titleComparison of mantoux and tine tuberculin skin tests in BCG-vaccinated children investigated for tuberculosisen_ZA
dc.typeJournal Articleen_ZA
uct.type.filetypeText
uct.type.filetypeImage
uct.type.publicationResearchen_ZA
uct.type.resourceArticleen_ZA
Files
Original bundle
Now showing 1 - 1 of 1
Thumbnail Image
Name:
Pan_Comparison_of_Mantoux_2009.pdf
Size:
114.23 KB
Format:
Adobe Portable Document Format
Description:
Download
Collections
Journal Articles