Published: 2016-12-22

Evaluation of BCG test in diagnosis of tuberculosis in BCG vaccinated children and its comparison with Mantoux test

Rafiq Anjum, Shazia Qayum, Anjum Rashid


Background:The prevalence of active disease in India is 15-25 per thousand population, 1/4th of them being open cases. The incidence of disease is 2-3% per year. The children are particularly susceptible because of malnutrition, overcrowding and lowered imunity. The infection in children is primary whereas adults have reactivation or secondary tuberculosis which is characterized by hypersensitivity and immunity to previous exposure. Mantoux test has been a useful diagnostic test for tuberculosis since long, but it could be false negative in proved cases of milliary tuberculosis, tubercular meningitis and disseminated forms especially in malnourished children.

Methods: The prospective study was conducted in a tertiary hospital of Northern India, included 100 children admitted in hospital with clinical suspicion of tuberculosis and having been previously and immunized with bacillus calmette-guerin (BCG) in infancy as evidenced by BCG scar.

Results:BCG test was positive in all 100 children (using modified Kenneth Jones criteria), 71% cases showed an induration of more than 10 mm while 29% showed induration of 7-9 mm. Most of case with 7-9 mm induration were either severely malnourished, having preceding history of pertussis/measles or longer vaccination intervals .The mean induration size observed was 11.0 mm.

Conclusions:Induration more than 10 mm with BCG or mantoux test can well be taken as indicative of fresh tubercular infection even in vaccinated children. The modified Keneth Jones criteria are useful clinical criteria for screening of suspected cases of tuberculosis.


BCG test, Mantoux test, Tuberculosis, Vaccination

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