A 5-year retrospective analysis of Mantoux test positivity in a tertiary hospital in Northeastern Nigeria

A 5-year retrospective analysis of Mantoux test positivity in a tertiary hospital in Northeastern Nigeria

Author by Dr. Opeyemi.olufeyisola Adesina

Journal/Publisher: International Journal Of Infectious Diseases

Volume/Edition: 16

Language: English

Pages: 289 - 289

Abstract

Mantoux test was introduced over century ago, is still used as a laboratory test in epidemiological studies of Mycobacterium tuberculosis infection (MTI) in most developing countries. Mantoux test is based on simple application but it could be limited by high false positive results. The cost limits the application of newer techniques. Therefore, we analyzed retrospectively the Mantoux test positivity in relation to clinical details suspected of MTI over 5-year period.

Methods: The 5-year retrospective study was carried out in the Department of Immunology and Infectious Diseases, University of Maiduguri Teaching Hospital, between 1999-2003. Data extracted were of patients with various clinical details of which Mantoux test requested. Mantuox test induration diameter of?>?5?mm is scored positive.

Results: Of 3218 patients examined, positive results recorded in 1532 (47.6%): 980 (30.1%) males and 562 (17.5%) females. Age-group distribution, 21-40 (27.0%),?<?20 (11.6%), 41-60 (7.2%) and?>?60 years (1.7) (p?<?0.05). Mantoux induration diameter, 10-15?mm (24.2%), >15?mm (15.8%) and 5-9?mm (7.6%) (p?<?0.05). Of 17 classified clinical details examined, positive Mantoux reactions were recorded in 13 cases (76.5%, 13/17). Pulmonary tuberculosis (518/1074, 48.2%), extra pulmonary tuberculosis (146/270, 54.1%), Pott's diseases (144/236, 61.0%), low back pain (94/132, 71.2%), orthoarthritis (26/42, 61.9%), retroviral infection (60/142, 42.3%), cervical lymphadenitis (24/44, 54.5%), fever/rashes (2/10, 16.7%), bronchopneumonia (54/184, 29.0%), weight loss (154/404, 37.6%), lymph node enlargement (26/54, 48.1%), others (186/428, 43.0%) and routine examination (100/160, 62.5%). Comparison of other details with PTB indicates that possibility of Mantoux test positivity is higher in Pott's disease [OR (95% CI)?=?1.33 (1.12-1.57), p?=?0.0001], Low back pain [OR (95%CI)?=?1.80(1.367—2.36), p?=?0.0001], and routine examination [OR (95%CI)?=?1.38 (1.121-1.70),p?=?0.001], while it is similar in extra-pulmonary tuberculosis [OR (95%CI)?=?1.13 (0.98-1.29),p?=?0.089], orthoarthritis [OR (95%CI)?=?1.36 (0.92-2.01), p?=?0.086], retroviral infection [OR (95%CI)?=?0.90 (0.77-1.04),p?=?0.21], cervical lymphadenitis [OR (95%CI)?=?1.14 (0.82-1.58),p?=?0.44], lymph nodes enlargement [OR (95%CI)?=?1.00 (0.77-1.30), p?=?0.99].

Conclusion: High Mantoux test positivity was recorded in diverse clinical details examined indicating different clinical presentations of MTI. Thus, utilization of this laboratory test should be collaborated with clinical indices and other tests to guide against false-positive results.


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