Advice 1: How to measure PPD

Mantu is a subcutaneous administration of tuberculin in the area of the forearm. At the injection site formed response immune response-type hypersensitivity. Its degree can help you to diagnose the development of TB and to assess whether the child needs to revaccination.
How to measure PPD
Reaction the skin test is evaluated strictly in 72 hours after tuberculin injection, and estimates the health worker. Try to check that the measurements of the samples were produced on time.
The measurement is performed with a ruler, positioning it perpendicular to the axis of the forearm. So measure the size of the papule – swelling of the skin in the area of injection of tuberculin. If the papule is absent, estimate the reddening of the skin (hyperemia).
Negative reaction the skin test is called a complete lack of any response of the body, respectively, in the injection is only from the injectors. The dubious result is a papule with a diameter of 2-4 mm or only hyperemia. The reaction of 5 mm or more having a positive reaction, if the size of the papule is greater than 17 mm, then such reaction is called a hyperergic.
Usually in children vaccinated against tuberculosis in the hospital, the first 5 years there is a positive reaction of Mantu, which fades over time. If it is negative, it indicates that the vaccination was ineffective in this case, vaccination must be repeated.
Hyperergic reaction, swollen lymph nodes, a red mark from the sample test to the elbow, and the appearance of bubbles in the area of sample introduction can attest to the fact that there was an infection with Mycobacterium tuberculosis. If your child has such a reaction, contact your TB doctor, he will appreciate it, is the true response or the false, will appoint the necessary additional examination.
Please note the contraindications for Mantoux test: skin diseases, epilepsy, exacerbation of chronic diseases, an Allergy, individual intolerance to the components of the sample.
Useful advice
In order to reduce the risk of false-positive reactions, make sure to drenched the area of the injection on the first day and not combed it.

Advice 2: On what day of the Mantoux test

Mantoux test was created to diagnose TB infection, which explains the procedures for samples every six months among children up to graduation.
Mantoux Test

Mantoux Test

Mantoux test is compulsory for all children aged one year to 18 years. If the child is not vaccinated with BCG vaccine, it is necessary to put the sample two times per year. The sample is made only by employees of the national health system trained in the TB dispensary.

Mantoux test is carried out with restrictions: it cannot be conducted at home or during quarantine for infectious diseases. Between the sample and test any preventive vaccine should pass one month. Exactly the same time you must wait after the child's recovery from any acute disease. Before the audition, each child receives a General physical examination.

Evaluation of Mantoux test

Capsules filled with Mantoux test tuberculin – allergen, unable to cause tuberculosis. However, reactions of the child's body for this test, the doctor can draw some conclusions. This explains the need for re-examination after the test.

While technically correct introduction of the allergen under the skin on its surface acts as a "lemon crust". In case of positive reaction it is replaced by the characteristic papule that looks like a normal mosquito bite.

Mantoux test is assessed 72 hours after injection. The doctor measures the size of papules by using a transparent ruler with millimeter divisions. He also measures the size of the infiltration in cross section. In the absence of papules recorded hyperemia.


negative reaction okolocha size of 1-2 mm;
- suspicious reaction is diagnosed when an infiltrate the size of 2-4 mm;
- positive reaction is diagnosed when infiltration size of 5mm or more;
- there is also the risk of the child giperergicakie reactions to the Mantoux test with a size of 17 mm and more.

If the child was vaccinated with BCG vaccine, the first 4-5 years of his life he will always be fixed firmly positive reaction greater than 5 mm, but not more than 16 mm. With age it gradually fades away. This phenomenon is considered perfectly normal and is called "post-vaccination Allergy.

However, there are other responses of the child's body, which suggests suspicions of the ineffectiveness of vaccination and re-execution. But the alarm when the PPD is accompanied by the appearance of vesicles or swollen lymph nodes. All these signs point to the fact the child transmission of the causative agent of tuberculosis.

Advice 3: How to measure forearm

Strictly speaking, the anatomy of the forearm is the part of the arm from the wrist to the elbow, however, in ordinary life, we call the forearm that is located below the shoulder – that is, the part of the arm from shoulder to elbow. How to measure this body part?
How to measure forearm
You will need
  • Measuring tape (meter or roulette), assistant.
For starters, be sure to find the assistant in the important matter of dimensions because to do everything yourself will be very problematic.
For the correct measurement of the volume of the forearm in the conventional sense (above the elbow) to the assistant grabbed the measuring tape in hand about 10 cm below the armpit. The arm should hang relaxed along the body. This place is – the widest part of the forearm, and its girth is correct. Keeping the measuring tape parallel to the floor, the helper is to circle around her hands and record the number seen. The tape should be free to "walk" around the hand, not clenching his and not causing inconvenience. It is this figure in the future will be useful in the preparation of patterns for the ladies, and men will be able to get your amount of biceps.
In order to measure the length of your forearm and bend your arm at the elbow. The assistant should attach the measuring tape to hand, stretching it from the bones at the bend of shoulder to tip of elbow. The resulting value is the length of the forearm.
In order to measure the length of the anatomical forearm (below the elbow), bend the arm at the elbow. The assistant should stretch the measuring tape from the tip of the elbow to the bones of the wrist, the one above which begins with palm. The resulting number will be the length of the anatomical forearm. They say that proportional people, this value must match the length of the foot. length of forearm assists in the preparation of patterns, especially the upper garment with short sleeves, a sleeve to the elbow" and "three quarters".
The volume of the anatomical forearm is narrow near the wrist place, that his girth is needed for proper cutting of the mouth of the sleeve of the garment. This value is your helper will get, tightly clasping the measuring tape around the narrow space of the hand over the carpal bone.
In different cases, you need to bend, then relax your hand, this will depend on the dimension.

Advice 4: Mantoux test in children

The Mantoux test - the main method of examination of children for tuberculosis. In fact it is an immunological test that shows the presence or absence of the infection in the organism of the child.
Mantoux test in children

How to carry out a Mantoux test

For the detection of TB infection to children under the skin are the product containing tuberculin. The skin in this place there is a specific inflammation (papule), which is caused by infiltration of lymphocytes (the blood cells responsible for immunity). The tuberculin will respond to only those lymphocytes that are already known to the tubercle Bacillus - the causative agent of tuberculosis. If the body is present, inflammation at the injection site will be more intense, and the Mantoux test will be called "positive".
Reaction to tuberculin is one of the varieties of Allergy.

On the second or third day after the injection, the doctor measures with a ruler the diameter of the papule and evaluates the immunity to the tubercle Bacillus. The Mantoux test is defined as follows. The sample is considered negative if the papule is absent, and kolochnaya reaction is equal to 0-1 mm. This result is the norm. If the injection site has redness, and the size of the infiltrate is 2-4 mm, the sample may be questionable.

The infiltration of 5 mm is typical for a positive reaction. In this case, the child may be referred for consultation to the children's tuberculosis specialist. Counseling is also necessary in the following cases:
- a sharp jump in the size of the papules compared with the previous result.
- sensitivity to tuberculin increases annually on the rise;
- the presence in the family of relatives, or those infected with tuberculosis.

Preventive screening for tuberculosis using the Mantoux test must undergo healthy children at the age of one year, regardless of which reaction was observed in the previous year.

Side effects, contraindications to the formulation of the Mantoux test

Mantoux test may cause the child allergic reactions and other side effects. Often there is dizziness and headache, fever up to 40oC, asthma attacks, vomiting, fevers, itching of papules. Some children with a high degree of delayed-type hypersensitivity, local allergic reactions may be accompanied by lymphadenitis, limfangoita, micronecrosis.

Contraindications to the production of the Mantoux test:
- skin diseases,
- acute somatic disease,
- exacerbation of chronic infectious diseases,
- allergic conditions
- epilepsy.
It is impossible to conduct a Mantoux test during the quarantine in the children's groups.

Setting Mantoux test should not be conducted on the same day with any other vaccinations. It is performed not earlier than one month after vaccination, when administered live strains of the pathogens, the interval should be increased to one and a half months.

Advice 5: Why do the Mantoux test

A Mantoux test done for over a hundred years, and still there is disagreement on this issue. Parents in recent years have increasingly began to refuse to vaccinate their children against infections, believing vaccinations are dangerous. However, people who become ill with tuberculosis, is becoming more and more every year.
Why do the Mantoux test

What is PPD and why it is needed

The Mantoux test is the main method of diagnosis of tuberculosis. It can help to determine the carrier "Bacillus" - a mycobacteria, the causative agent of this dangerous disease. The bacterium was discovered in 1882, German biologist Robert Koch, had developed a drug tuberculin, which was used for the diagnosis of tuberculosis.

If the body has already met with live Mycobacterium tuberculosis and, accordingly, have developed antibodies against it, it will react to the introduction of the drug the abundant redness, allergic reactions and hardening at the injection site. If, on the contrary, did not face, any reaction will not follow.

Mantoux test is done annually when the child reaches one year of age. The tuberculin is injected subcutaneously in the arm on the inner side of the forearm. Tuberculin – non-living vaccine is harmless in the quantities necessary to conduct the Mantoux test.

To comb and RUB the injection site the skin test is not within 2 – 3 days. After this period, inspecting vaccination – record, its size, convexity, and color. When the size of the "buttons" from 5 mm to 15 mm Mantoux test is considered positive, that is, the TB bacteria in the body is found. Further actions will be directed to take additional tests to clarify the diagnosis, since in itself both a positive and a negative sample may not talk about the presence or absence of the disease.

It is important to trace in dynamics the Mantoux test. Every year the "button" should be reduced in diameter or remain the same.

What you need to know

Carriers tuberculin sticks are many, but sick one. This happens if the body is weakened or the immune system fails, or people living in very poor conditions – does not comply with hygiene and poorly fed. The risk group includes people with diseases of diabetes, HIV and other chronic illnesses.

If the baby in the hospital made the BCG vaccination, and that vaccination against tuberculosis, it does not guarantee that he will not get sick in the future, but is likely to take the disease in a mild form.

Contraindications for the production of the Mantoux test are transferred in the recent time of illness, the disease in the current time period or recent vaccination other vaccinations. In this case, it is recommended the postponement of the tuberculin reaction in different for each case period.
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