Tuberculin Mantoux test, commonly called "'Buttons'", is a specific diagnostic test (not to be confused with vaccination!) used for mass screening of the population for tuberculosis.

To conduct tuberculin tests, tuberculin is used, which by its composition is a complex compound. It does not contain live or killed mycobacterium tuberculosis, but only products of their vital activity, elements of the microbial cell and part of the environment on which the mycobacterium tuberculosis grew.

An allergic reaction (positive tuberculin test) occurs to tuberculin injection in those vaccinated with BCG vaccine against tuberculosis (postvaccinal allergy) and in those infected with Mycobacterium tuberculosis (infectious allergy). In both cases, tubercle bacilli are present in the subject's body. Only in the first case they were introduced with the BCG vaccine and maintain immunity to tuberculosis, and in the other case they entered the body from the environment and are virulent, i.e. under certain conditions they can cause disease. The Mantoux test is not an immunization; it is a method of detecting the incidence of tuberculosis.

Objectives of mass tuberculin diagnostics:

- identification of persons infected with MBT for the first time ("virage" of tuberculin samples);

- identification of persons with hyperergic and increasing reactions to tuberculin;

- selection of contingents for TB vaccination with BCG-M vaccine of children aged 2 months and older who were not vaccinated in the maternity hospital and for revaccination with BCG vaccine; early diagnosis of tuberculosis in children and adolescents;                   

- Determination of epidemiological indicators of tuberculosis (infection rate of the population with MBT, annual risk of infection with MBT) -In mass tuberculin diagnostics only a single intradermal Mantoux test with 2 tuberculin units (TU) of purified tuberculin in standard dilution (ready-made form) is used.

Objectives of individual tuberculin diagnostics:

- differential diagnosis of postvaccinal and infectious - allergy to tuberculin;

- diagnosis and differential diagnosis of tuberculosis and other diseases;

- determination of the "threshold" of individual sensitivity to tuberculin;

- determination of the activity of the tuberculosis process;

- evaluation of the effectiveness of tuberculosis treatment

It is carried out annually, and some categories of children (chronic lung diseases, kidney diseases, diabetes mellitus, hormone treatment, HIV infection, etc.) 2 times a year. The Mantoux test is absolutely harmless for both healthy and sick children.

Contraindications to the Mantoux test:

- Skin, acute and chronic infectious and somatic diseases in the period of exacerbation;

- Allergic conditions, rheumatism in the active phase, bronchial asthma in the exacerbation stage;

- In children's collectives on quarantine regime;

- 1 month after immunization.

Mantoux test is put 1 month after the disappearance of clinical symptoms or immediately after the removal of quarantine.

Record the results after 72 hours:

- negative test - with complete absence of changes in the skin, or "prick" reaction;

- doubtful - hyperemia (spot) of any size or papule (bump) 2 - 4 mm;

- positive - papule (bump) 5 mm and more;

- hyperergic - papule 15 mm or more and/or vesicular rash, inflammation of lymph nodes at any size of papule.

Normally within 2-4 years after BCG vaccination the Mantoux test is positive, this is the so-called post-vaccine allergy, the size of the papule decreases by the age of 4 and becomes negative. If during the year the child is infected with tuberculosis, the size of the papule increases dramatically, and it becomes positive. Such children need urgent follow-up examination and consultation in the TB dispensary. The referral is given by a district pediatrician or a doctor of a child care facility.

Ukumatshoeva L- lecturer of the department of phthisiopulmonology

translated Ismoilov R.