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Contact tracing / pre-employment screening for pulmonary tuberculosis: Should positive mantoux test necessitates routine chest X-ray?

Usmanu Danfodiyo University Teaching Hospital
Publication Date
  • Chest Radiography
  • Contact Tracing
  • Mantoux Test
  • Pulmonary Tuberculosis
  • Biology
  • Economics
  • Medicine


Background: Pulmonary tuberculosis (PTB) remains a scourge in most developing countries. Mantoux skin test andmore commonly chest radiography are some of the methods of diagnosing the disease, especially with regard tocontact tracing and pre-employment screening. Regular use of radiography has both safety and cost implications.This study aimed at establishing if any justification exists in requesting for chest radiographs in asymptomatic subjectswith a positive Mantoux skin test reaction.Methods: 174 adults comprising PTB contacts and newly employed/admitted university staff/students were recruitedinto the study. They were 89 males (51.1%) and 85 females (48.9%). All subjects had Mantoux test (using purifiedprotein derivative, PPD). Patients who had positive Mantoux reaction subsequently were subjected to posteroanteriorchest radiographic examination. Mantoux test and chest radiographic findings were then correlated with each other.Results: 102 subjects (59.2%) had positive Mantoux reactions, while 27 subjects (31.1%) had abnormal chestradiographs. There was no significant correlation between Mantoux readings and chest radiographic findings(P=0.106).Conclusion: It is concluded that other ancillary tests like sputum examination and/or, where available, Interferon andESAT tests should be carried out before chest radiograph is requested in subjects with positive Mantoux reaction.

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