Pediatrics Infectious and Tropical Diseases Unit, Department of Pediatrics, Hospital Carlos III, Sinesio Delgado 10, 28029 Madrid, Spain.
Indian J Pediatr. 2013 Apr;80(4):271-5. doi: 10.1007/s12098-012-0773-1. Epub 2012 May 13.
To evaluate Tuberculin skin test (TST) results in a population of immigrants and internationally adopted children from several geographical areas; to analyze whether nutritional status can modify TST results.
This cross-sectional observational study included adopted children and immigrants evaluated in the authors' unit between January 2003 and December 2008. Children diagnosed with tuberculosis, or vaccinated with live attenuated virus 2 mo earlier, HIV-infected, chronically ill or under treatment with immunosuppressive agents were excluded. TST was considered as dependent variable. Independent variables were gender, age, geographical origin, BCG scar, nutritional status, immune status and intestinal parasitism.
One thousand seventy four children were included; 69.6 % were girls. There was a BCG scar in 79 % of children. Mantoux = 0 mm was found in 84.4 %, <10 mm in 4.1 %, and ≥10 mm in 11.4 % of children. Nutrition (McLaren's classification) was normal (≥90 %) in 26.7 % of the subjects, with mild malnutrition (80-89 %) in 36 %, moderate (70-79 %) in 23.2 % and severe (≤69 %) in 14.1 %. There was no difference in TST results among different nutritional status children.
The nutritional status, measured by McLaren's classification, does not changes the results of TST. McLaren's classification only grades protein-caloric malnutrition, so in authors' experience this type of malnutrition does not interfere with TST results. Implementing other nutritional parameters could help to determine whether nutritional status should be taken into account when interpreting TST results.
评估来自不同地理区域的移民和国际收养儿童的结核菌素皮肤试验（TST）结果；分析营养状况是否会改变 TST 结果。
本横断面观察性研究纳入了作者单位于 2003 年 1 月至 2008 年 12 月期间评估的收养儿童和移民。排除患有结核病、2 个月前接种活减毒病毒疫苗、HIV 感染、慢性疾病或正在接受免疫抑制药物治疗的儿童。TST 被视为因变量。自变量为性别、年龄、地理来源、卡介苗疤痕、营养状况、免疫状况和肠道寄生虫感染。
共纳入 1074 名儿童；69.6%为女孩。79%的儿童有卡介苗疤痕。84.4%的儿童曼图试验结果为 0 毫米，4.1%的儿童结果为＜10 毫米，11.4%的儿童结果为≥10 毫米。26.7%的受试者营养状况（McLaren 分级）正常（≥90%），36%为轻度营养不良（80-89%），23.2%为中度营养不良（70-79%），14.1%为重度营养不良（≤69%）。不同营养状况儿童的 TST 结果无差异。
McLaren 分级测量的营养状况不会改变 TST 结果。McLaren 分级仅对蛋白质-热量营养不良进行分级，因此在作者的经验中，这种类型的营养不良不会干扰 TST 结果。实施其他营养参数可能有助于确定在解释 TST 结果时是否应考虑营养状况。
