Tuberculin Skin Test, chest radiography and contact screening in children ≤5 y: relevance in Revised National Tuberculosis Control Programme (RNTCP).
OBJECTIVE
To ascertain the status of Tuberculin Skin Test (TST) in the children aged 0-5 y who are household contacts of adults having sputum smear positive pulmonary tuberculosis and also to study the relationship of TST and Chest X-Ray (CXR) and their relevance in contact screening under RNTCP setup.


METHODS
This prospective hospital based clinical study was conducted at a tertiary level referral medical college in Northern India. Study subjects were 200 children ≤5 y of age who were household contacts of adults with sputum smear positive pulmonary tuberculosis. All these adult index cases were registered and taking regular treatment at RNTCP centre attached to a medical college. Demographic data collection, detailed clinical history along with clinical examination, growth assessment, TST and chest radiography (CXR) was done for every child.


RESULTS
TST was positive in 39 % children and out of these 68 % of child contacts had CXR findings suggestive of tuberculosis. This correlation was found to be highly significant (p < 0.001), especially in children less than 1 y of age. A high percentage of clinically asymptomatic children also had positive TST and CXR consistent with definition of TB disease.


CONCLUSIONS
Contact screening must be prioritized in RNTCP. Unlike presently, TST and CXR should be actively employed in RNTCP for contact screening.
Department of Pediatrics, Sri Ram Murti Smarak Institute of Medical Sciences, Bareilly, Uttar Pradesh, India. drsandhyapedia@gmail.com
Sandhya
S
Chauhan
Pratik
P
Gahalaut
A K
AK
Rathi
D000328:Adult; D002675:Child, Preschool; D016358:Contact Tracing / Q000706:statistics & numerical data; D005260:Female; D006784:Hospitals, Teaching; D006801:Humans; D015994:Incidence; D007194:India / Q000453:epidemiology; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D044342:Malnutrition / Q000150:complications; D008403:Mass Screening / Q000379:methods*; D009313:National Health Programs / Q000706:statistics & numerical data; D011446:Prospective Studies; D012307:Risk Factors; D014057:Tomography, X-Ray Computed; D014374:Tuberculin Test / Q000379:methods; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000276:immunology* / Q000517:prevention & control