Treatment of tuberculosis, if this is not the initial stage, is very long and requires the use of drugs with a negative effect on the body. In order not to bring the disease to a severe phase, when it is difficult to cure it, and it has already caused irreversible damage, an analysis is performed that determines the presence of a tuberculosis bacillus.
The Mantoux reaction is the most popular way to detect Koch's sticks in the human body. However, such a tuberculin test is not the only method by which tuberculosis can be detected. Let's talk about whether a blood test for tuberculosis is a full-fledged alternative instead of Mantoux tuberculin diagnostics, and whether there are any other options for detecting the causative agents of this disease.
The most popular test for detecting tuberculosis is known as the Mantoux test. The technique is used to detect tuberculosis infection based on a specific local skin reaction that appears (where tuberculin was injected). The advantages of the Mantoux test include simplicity, painlessness, and the fact that it can be used to examine children.
At one time, the tuberculin test was indeed the most accurate, but many decades have passed since then, and other diagnostic methods have appeared - more informative and accurate ways to detect tubercle bacillus in the body. However, due to the continuous nature of checks among preschoolers and schoolchildren, it remains a “no alternative” method of tuberculin diagnostics, the reason for which, to a greater extent, is bureaucracy.
The Mantoux test is widely used to detect allergies (before BCG vaccination) and as a post-vaccination conversion control. Tuberculin diagnostics does not involve the introduction of live or inactivated tuberculosis mycobacteria, which is a plus, since there is no likelihood of infection, albeit a minimal one. It is allowed to perform for patients with chronic diseases of the heart, gastrointestinal tract, musculoskeletal system, and so on.
The reaction of the body to Mantoux allows us to give a preliminary conclusion about the presence or absence of tuberculosis, and this is a positive thing. But the answer is not always unambiguous, and this is the negative side. Each organism is unique, so the tuberculin test can sometimes give false responses. That is, a positive reaction can be observed in the absence of the disease.
Contraindications for Mantoux
There are contraindications to the Mantoux test, so a preliminary examination by a doctor is necessary. There are many disadvantages of this diagnostic method. To test for tuberculosis, it is sometimes better to resort to alternative methods.
One of the drawbacks is ambiguity. There is a widespread misconception that the "big Mantoux" speaks of the development of the tuberculosis process. It has been established that sizes exceeding a certain threshold do not help in the unambiguous interpretation of the test. An enlarged papule does not provide reliable information about the activity or inactivity of the disease, about distant infection or recent.
60% of TB patients have dubious samples, and positive ones are often recorded in those who are completely healthy, that is, there is a high probability of a false reaction. Tuberculin test may be positive after BCG immunization. It does not provide information about the form of the disease and the localization of the process, complications are likely.
Cases of false-positive reactions have been recorded when chemicals are injected at the injection site (for example, shampoo, although there is no exact evidence), as well as when using certain foods and drugs (and here, too, there is no unequivocal opinion on exact correlations).
The test is influenced by the individual reaction of the body to tuberculin, the presence of helminthic invasion and chronic diseases. There are also difficulties in identifying Koch's sticks if a person is allergic, there are skin pathologies.
From the moment of recovery from the disease, which proceeded in an acute form, at least a month should pass. Similar rules apply to quarantine measures in preschool educational institutions and schools (Mantoux is set only a month after they end). It is important to maintain the same interval if they are vaccinated.
This type of diagnosis cannot be prescribed on the same day as routine vaccination. The delay in obtaining a Mantoux test result is another disadvantage, especially when compared to alternatives. The check is carried out in two or three days, a maximum of a week.
The release form of the drug is a solution for injection.
Blood tests as alternative methods for diagnosing tuberculosis
Tuberculosis is dangerous and difficult to cure, the result depends on how early the disease was detected. In the absence of timely therapy, a mild sluggish form turns into a severe one. For this, systematic examinations are needed to detect the presence of Koch's wand. What to do instead of the Mantoux reaction?
Linked immunosorbent assay
The antibody test (ELISA) is highly sensitive, simple, but not cheap. It is based on the strict selectivity of antibodies that react exclusively with certain antigens. The result is influenced by food, allergens, drugs. A false positive result (as opposed to a false negative) is excluded. ELISA does not reveal the stage of the disease, and of all forms of tuberculosis, it most effectively detects bone disease. It does not give a 100% guarantee, since the presence of antibodies to tubinfection does not always indicate the disease.
Biochemical analysis
A biochemical blood test is useless at almost any stage of the disease, especially with a latent form. It is informative only in acute (shows a reduced concentration of albumin-globulin). A large number of leukocytes and eosinophils makes it possible to judge specifically about tuberculosis infection, and not about other pulmonary diseases. A high level of ESR speaks not only of tubinfection, but also of other infectious or inflammatory processes. The method is more suitable for monitoring the effectiveness of therapy. In the case of unclear results of the Mantoux test, he will not add unambiguity.
T-SPOT study
The method allows to identify the disease with a certainty of 97%. In a blood sample, the number of lymphocytes involved in the production of interferon gamma is determined. The immune response indicates the unequivocal presence of tubinfection. T-POS reveals even a latent form, is applicable for allergy sufferers and those suffering from chronic diseases, is less dependent on the influence of BCG, does not give a false positive result, has no contraindications, can be done to a child.
Is it possible to replace Mantoux with a blood test: comparative characteristics of the reaction
And really, can it be better to hand over a blood for check? No. A blood test only allows us to state the fact of a change in the leukocyte formula, that is, it informs about the presence of any inflammatory process, but not specifically tubinfection.
It is known that the composition and properties of blood vary depending on the stage of tuberculosis. In the latent form and at the beginning of the disease, the number of monocytes decreases, the number of neutrophils increases, in the active form, the number of lymphocytes increases, and the number of neutrophils decreases. In the absence of tubinfection, the proportions of blood particles are close to normal (if there are no other infectious diseases).
What other analysis can be taken instead of Mantoux
X-ray is informative, but is not done for young children, as it negatively affects the growing body, and can be prescribed in exceptional cases. It is used as a method of additional diagnostics, with already detected tubinfection using other methods. X-ray shows pathological foci in the lungs, suitable only for detecting the pulmonary form of tuberculosis. It gives a quick result and at the same time reports the presence or absence of other pulmonary abnormalities.
The PCR method (polymerase chain reaction) is considered a good alternative to classical diagnostics. It is highly sensitive (accuracy approaches one hundred percent), detects any tuberculosis forms, and is harmless. PCR for tuberculosis instead of Mantoux is not recommended during the post-vaccination period and immediately after anti-tuberculosis therapy. Due to the fact that the remains of mycobacteria are still present in the body, this affects the result, since the presence of Koch's sticks is fixed, without distinguishing whether they are alive or not. So the test will be positive.
The quanteferon test provokes an immune response to tuberculosis infection, has no contraindications, is safe, but expensive. A positive test result does not always indicate infection, and a negative one does not exclude an active disease (does not reveal it in a quarter of patients). Applicable for the detection of a latent form of tuberculosis, after performing BCG. At the same time, the technique does not distinguish between the latent form of the disease and the active one. The accuracy of detecting tubinfection is 99%, but the probability of an erroneous result is also high.
Suslov's test is a blood test. Based on specific features, a conclusion is made about the presence or absence of Koch's bacillus in the biomaterial. It is chosen in the presence of allergies and in young children, it is harmless, but has a significant drawback, which consists in poor sensitivity. It is based on the use of complexone and tuberculin, and is one of the rarest. It is problematic to identify lung diseases in this way.
Diaskintest is based on the reaction of the skin to recombinant tuberculous protein. It is an improved version of the Mantoux test. The immune response is assessed after three days by measuring the diameter of the papule. The positive aspects of diagnostics include high accuracy and simplicity. Minus - in the presence of other infectious diseases, there is a high probability of a false result and an adverse reaction in the form of a general malaise. This method of research has become very popular in recent years.
The Ziel-Nielsen technique detects the presence of tubinfection by a specific analysis of saliva. The method is complex and includes a series of successive chemical reactions. Harmless, applicable to children, allergy sufferers, in the presence of chronic diseases. It simply fixes the presence of a tubercle bacillus in the body, without revealing the degree of the disease, localization and other features, it is almost not common.
Urinalysis, as an alternative to Mantoux, is not informative enough. Tuberculous microbacteria are often present in the urinary system when the disease is present, which indicates the presence of the disease, but not always. The method is suitable for diagnosing extrapulmonary tuberculosis forms, it is harmless, but food, drugs, and lack of sterility affect the information content. The presence of Koch's bacillus in the urine is determined by one of three methods: bacterioscopy, bacteriology, bioassay. Not suitable for detecting tubinfection at a young age in children.
Phase contrast microscopy allows the observation of live tuberculosis mycobacteria. The technique involves the use of special equipment. Diagnosis is safe, allowed even for small children, but not common in our country. It does not give false-positive and false-negative results, allows you to state the stage of the disease and its various forms.
Luminescent microscopy is based on the reaction of affected areas to ultraviolet rays. Detection is based on the fact that with such exposure, tuberculous mycobacteria begin to glow. The technique allows to detect tuberculosis infection of various localization, does not give erroneous conclusions, but is not common.
Where is the best place to test a child?
The Mantoux test when examining children in Russia is mandatory. In addition, everyone undergoes preventive medical examinations, which, as a rule, include this tuberculin test. If, for some reason, the Mantoux test was missed by the child, or the injection was not given at all, it will definitely have to be done in the clinic, otherwise there may be problems with admission to the preschool or school.
Identification of the disease using alternative methods is carried out in private clinics. Experts advise to conduct at least two different tuberculosis tests, preferably in different medical facilities.
Tuberculin diagnostics (Pirquet test, Mantoux reaction) is a skin or intradermal test for the presence of tuberculosis bacteria in the body. If a child is allergic to mantoux, then alternative studies are carried out.
Blood test for tuberculosis
An enzyme-linked immunosorbent assay (ELISA) detects AMG immunoglobulin for tuberculosis. Blood is taken from a child's vein on an empty stomach exclusively in the laboratory. The turnaround time for results is one day. Plus ELISA - accuracy, shows the presence of other diseases. Minus ELISA - detects the presence of bacteria already at the stage of infection.
ELISA is not a complete replacement for Mantoux. The test only helps to see changes in the leukocyte formula.
The composition and properties of blood vary depending on the stage of tuberculosis:
- When infected, the number of lymphocytes and monocytes decreases, and there are more neutrophils.
- In the active phase of tuberculosis, the leukocyte formula shifts to the left. There are more lymphocytes and fewer neutrophils.
- In the absence of tubercle bacillus, the blood formula is normal.
Diaskintest instead of Mantoux
Diagnosis of tuberculosis in children without Mantoux is carried out using the drug Diaskintest. This genetic engineering product was developed by Russian scientists using nanotechnology. The composition of the drug does not contain Koch's sticks. Diaskintest contains recombinant tuberculosis protein.
The effect of the test is based on the development of an immune response in the child's body. A protein is injected under the skin on the back of the hand and the reaction is observed. The result of the study is evaluated after three days. Measure the hyperemia of the area around the site of the sample:
- If the result is negative, only a trace of the injection is visible, a bruise up to 2 mm in diameter and a slight induration under the skin (no more than 1 cm).
- With a false positive result, redness (more than 4 mm) is visible, the appearance of an allergic reaction to the components of the drug.
- With a positive result, if the size of the swelling at the injection site reaches a diameter of 5 mm, then there are few agents of tuberculosis in the body, if up to 9 mm - a moderate amount, and more than 10 mm - a pronounced amount.
The advantage of the method is the high accuracy of determining the presence of infection.
The disadvantages of diagnosis are a false result in other inflammatory processes or a weakened immune system. Adverse reactions - malaise, fever.
Suslov's test for children
For the test, blood is taken from a finger. Complexone and tuberculin are injected into a test tube with blood. The result of the analysis is visible after 5-6 hours. According to certain signs, a conclusion is made: positive, negative or doubtful. The advantages of the Suslov test are informativeness and accuracy, the absence of an allergic reaction and toxicity. The disadvantage is the low sensitivity of the analysis.
Urinalysis for tuberculosis
Urinalysis helps to recognize the presence of the pathogen if the disease has already progressed and affected the urinary system. In other cases, the analysis is done in combination with Diaskintest or PCR diagnostics. The advantage is that the infection is detected outside the child's body, there are no side effects. The disadvantage is that it does not give 100% results.
Quantiferon test
The essence of the technique is to obtain an immune response to the Koch stick. Based on the indicators of the level of interferon gamma in the blood, a conclusion is made about the absence or presence of tuberculosis. The study time is from 3 to 10 days. Deciphering the result is in three versions: positive, doubtful or negative.
The test is absolutely safe, has no contraindications.
The quantiferon test detects mycobacterium tuberculosis in 99% of cases even during the incubation period. Disadvantages:
- the probability of a false result is 11%;
- it is not possible to conduct a quantiferon test in every city;
- high cost of analysis - up to 4500 rubles.
PCR instead of Mantoux
Polymerase chain reaction (PCR) is an excellent alternative to Mantoux for a child, judging by the feedback from parents. This is a very sensitive technique that detects not only Koch's sticks, but also the causative agents of many other diseases. PCR as an alternative to Mantoux is used during the diagnosis of any tuberculosis forms.
Blood, mucus, sputum, gastric contents are used to detect mycobacteria. PCR analysis takes place in 3 stages:
- DNA fragments are isolated using a special liquid.
- The solution is subjected to amplification of DNA fragments in a thermostat.
- The pathogen is recognized.
The diagnostic result is ready in a few hours (4-6).
The main advantages of PCR are almost 100% reliability and the absence of side effects.
The disadvantage of the technique is that there is no difference between a dead pathogen and a living one. This means that the child after treatment may have the remains of dead tissue of mycobacteria, that is, be healthy, and PCR gives a positive result.
Diagnosis by x-ray
X-rays are not recommended for children. This analysis negatively affects the baby's body. It is prescribed to confirm the diagnosis if the Mantoux reaction is positive. In this case, doctors can easily determine the foci of pathology on an x-ray.
During the examination, X-rays pass through the body. They are projected onto an electronic matrix, fluorescent screen, film cassette. The result depends on the density and structure of the tissues. The presence of lesions - X-ray negative tissue. Healthy areas are called radiopositive.
To determine the foci of tuberculosis, fluorography and tomography are used. The first technique is more often prescribed for children, since it has less negative impact on the body. With fluorography, the image displayed on the screen is simply photographed, and with computed tomography, the body carries a radiation load.
The advantages of x-rays are the accuracy of determining the disease, quick results (within a few minutes), and the detection of concomitant pathologies. Minus - radiation exposure, which is not suitable for young children (under 14 years old).
Video
Modern medicine knows many types of tests that help to establish diseases in the early stages. One such disease is tuberculosis. A blood test for tuberculosis instead of Mantoux helps to determine the disease even at the initial stages, which does not guarantee a 100% Mantoux test.
Tuberculosis is a very complex and serious disease that cannot be cured in a week. More than 30% of the world's population suffer from this disease, and the strongest drugs are required for treatment. The duration of treatment can vary from six months to one year, depending on the degree of the disease.
The scientist Robert Koch discovered the bacillus, and the method of dealing with it, the Mantoux test, was invented by the French physician Charles Mantoux.
Why is the bacillus so dangerous. It is very easily transmitted from a sick person to a healthy person by air and droplets or household items. Moreover, the tubercle bacillus can be on the surfaces of objects for a long time and not die. A disease without treatment can affect all human organs. Such people do not live long, a maximum of six years. In order to prevent the spread of tuberculosis, Mantoux vaccination or other blood tests are done.
Many people are interested in what are the blood tests and how are they taken? How can an ordinary person determine whether he has tuberculosis or not? Any person should have a minimum of knowledge about blood tests for tubercle bacillus. Understanding this is not difficult and does not require medical qualifications.
Features of the Mantoux test
The Mantoux test is a vaccine that is injected under the skin. Mantoux contains a small dose of tuberculin and the reaction is similar to an allergy. At the injection site of tuberculin, redness and a button are formed, the size of which determines the presence of Koch's bacillus in the body. If the reaction is positive, then this does not mean that the person is sick. The sample itself does not give a 100% guarantee of the presence of bacteria, and additional types of diagnosis will be required.
If the button does not exceed 1 mm, then the person did not encounter Koch's wand. If the body is infected with Koch's wand, then the reaction will be pronounced. However, the result may be affected by allergies or skin diseases, which will lead to a false conclusion. The result should be especially alert for the button diameter of 4 mm and redness. This indicates a strong immune system capable of fighting the virus. In such situations, a blood test for tuberculosis is prescribed instead of Mantoux. Currently, other research methods are presented.
Other research methods
In addition to the Mantoux test, there are other types of analyzes:
- bronchoscopy;
- sputum analysis;
- enzyme immunoassay ELISA;
- PCR or polymerase chain reaction and means obtaining a copy of DNA enzymes;
- biochemical research;
- general blood test;
- quantiFERON-TB Gold - quantinferon test;
- IGRA.
Currently, another test has been introduced in Russia, it is called diaskintest and has many advantages. One of them is that there are no contacts with blood, but they help to remove Koch's wand.
Of the assays listed, QuantiFERON-TB Gold and IGRA are rarely seen on screenings. They represent screenings and indicate the presence of antibodies. In Russia, such methods are practically not used.
Sometimes Mantoux can be replaced with a Quantiferon test for children who are allergic to Mantoux. But without additional checks in case of detection of the disease can not do. However, the Quantiferon test does not determine which type of disease is incubative or active.
A similar method to the quantiferon test is the Interferon Gamma Release Assays (or IGRA). It correctly indicates the presence of bacteria in the body.
If necessary, a biochemical blood test is prescribed, which checks the level of protein. If tuberculosis is in a passive form, then the protein will be normal. If it is acute, then cholesterol, urea and lysozyme increase.
Additional tests of saliva and urine, semen and sweat will be needed to diagnose extrapulmonary TB.
Blood tests ELISA and PCR
An enzyme-linked immunosorbent assay (ELISA) of blood is a quick and convenient method and is done frequently, replacing Mantoux. In this study, blood is taken from a vein. This is a completely acceptable option, however, it cannot answer the question at what stage the disease is. This procedure helps to detect only the presence of antibodies. Currently, the ELISA is considered not very reliable.
A PCR blood test is the preparation of a copy of the DNA enzymes of tuberculosis bacilli. Such a study is more productive. This is a modern method that allows you to identify Koch's wand. The basis is the search for bacillus DNA.
The blood test is more credible. The advantage of this assay is the small time span of five hours. This diagnostic has proven itself positively, is more often used in blood tests and is based on the detection of tuberculosis through a chain reaction.
In addition, it allows you to show the number of bacilli, and this is not carried out by enzyme immunoassay. If it is necessary to urgently make an analysis and identify the source of infection, then this analysis is used. We can say that such a study is more effective and has the right results compared to other analyzes. However, it does not show the local focus of the development of the disease. Additional checks will be needed: an x-ray and a urine test.
General blood test
In some situations, a general blood test is taken at the initial stages of the disease. If the Mantoux test turned out to be positive, then a general blood test can be done. With tuberculosis, changes occur in the composition of the blood. Such an analysis really helps to find out about the presence of the disease at a later stage. At the initial stages of the disease, the blood does not change, so it makes no sense to donate it.
General analysis and what they pay attention to. The fundamental indicator is ESR and it changes depending on age. In children it is up to 10 mm/h, in adults up to 30 mm/h. In patients with tuberculosis, it reaches up to 50 mm/h. Also an indicator of infection is the growth of eosinophils, an increase in the number of leukocytes and a decrease in the level of hemoglobin and lymphocytes.
Who needs to donate blood for tuberculosis
Donating blood is necessary for people who fall into a dangerous group. These are doctors, employees of prisons, homeless shelters, anti-social individuals, drug addicts and alcoholics, AIDS patients and those who have reduced immunity and who have done chemotherapy. Dangerous are sick people who have an open type of tuberculosis. People who have been in contact with a sick person should also be tested.
It is advisable to donate blood for infection to citizens who have visited places with a high degree of infection - India and China, South Africa and Pakistan, Nigeria and Indonesia.
Blood is donated on an empty stomach. Before this, it is contraindicated to drink alcohol and drugs that may affect the conclusion.
Individuals with permanent bronchitis or frequent pneumonia can be referred for x-rays. The dangerous group includes patients with diabetes, permanent adrenal insufficiency, stomach ulcers, as well as those who have undergone surgery to remove the ulcer.
The analyzes do not require special preparation. The only thing the doctor can say is what to exclude from food or medicine before diagnosing.
Only a pulmonologist decides which additional tests need to be taken, because one blood test may not be enough.
In addition to fluorography, patients take an X-ray image in a lateral image. Expensive, but the most correct will be a computer or magnetic and resonance imaging.
Conclusion
Children at school are mainly prescribed Mantoux, enzyme immunoassay is rarely used, and adults are mainly prescribed a PCR blood test.
Yes, tuberculosis is just hell, weakness, depression, chest pain, hemoptysis and not wanting to live. But you should never give up and fight for your life. She is one and will not be another.
With proper treatment and following the instructions of the diet, breathing exercises and a positive attitude, the disease can be overcome and live a long and happy life.
Medicine has reached such a level of development that with the help of analyzes it is possible to determine almost any disease of the human body. Unfortunately, there are a lot of diseases in the world.
It's time to write about tuberculosis. This is a rather specific disease that may not manifest itself for a very long time.
According to statistics, they suffer from about thirty percent of the population of our planet.
Almost everyone knows the fact that it can be cured only after a certain time, and the treatment can be very difficult.
For treatment, long-term procedures and drugs with a fairly strong effect on the human body are used.
Despite the fact that medicine has taken a step forward in development, an increase in the number of patients with this disease is recorded in the world.
This is primarily due to the fact that the infection is easily transmitted to a healthy person from a sick person.
It is important to remember that in addition to adults, children are also susceptible to infection. Therefore, in order to prevent tuberculosis in children at school age, mantoux is made.
At school, in principle, they are accustomed to such an inoculation and are familiar with its features. Mantoux is an intradermal vaccination that helps to detect tuberculosis at an early stage and see if the child's body is predisposed to the disease.
The test is usually accompanied by inflammation. And this shows the body's ability to produce antibodies to tuberculosis. If the body has previously had tuberculosis in a child, or the risk is very high, then the inflammation will be very pronounced.
After a certain time, the vaccination is examined, which will reveal the degree of readiness of the body to face the disease. The norm in children is about one millimeter of mantoux - this is a slight inflammation around the injection on the child's arm.
Mantoux with tuberculosis in children has dimensions of seventeen millimeters and above, that is, it reveals infection of the child's body. But such reactions in an adult cannot be unambiguously interpreted.
Most likely, the person has recently had an infectious disease, or suffers from allergies. Accurate diagnoses can only be recognized by a specialist in this field.
A mantoux test for tuberculosis is carried out once after a certain time. It is compulsory at school.
Of course, mantoux is considered a mandatory procedure in schools, but more and more parents are abandoning it in favor of more advanced methods for detecting the disease at an early stage.
And more and more often they are wondering how to test a child for tuberculosis without mantoux. There are many different tests and only a few of the most effective procedures for detecting tuberculosis will be given below.
But, contrary to the obligatory order, mantu has anti-tuberculosis care on a voluntary basis. Parents can simply write a refusal if they do not see the need for it.
Mantou alternatives for kids
In addition to mantoux, you can take tests for tuberculosis, which will also help diagnose the disease in a child.
A blood test for tuberculosis instead of a mantoux in children is aimed at antibodies that should be in the body.
A general blood test for tuberculosis can also be done, but it will show the disease only when the body is already affected. A special test for tuberculosis is called an enzyme immunoassay.
A blood test for tuberculosis in children has its inaccuracies and shortcomings. But its plus is that this analysis can show the presence of other diseases in the body.
Unlike mantoux, tuberculosis screening is much more accurate.
It is used only in countries where tuberculosis infection is very low. But the advantage is obvious: an affordable price and a fairly accurate result.
In our time, under our circumstances, parents are increasingly using it so that the child does not make mantoux.
To do this, during the examination, you simply go to the doctor and ask if it is possible to do a blood test for tuberculosis.
Usually they agree and go to the meeting. Diagnosis of tuberculosis in children without a mantoux may include PCR for tuberculosis.
It can be described as more comfortable and accurate in this area. It has no age restrictions and can be used even by children.
Diagnosis of this type is based on the detection of tuberculosis as a result of the polymerase chain reaction. It is widely used in various sciences.
This technique allows you to detect the presence of a virus in the body in the first stages of infection, up to an hour. Very often, people who have recently been ill can again succumb to this disease.
Therefore, it is this type of diagnosis that is used to detect relapse. It takes very little time, but gives a fairly reliable result. In addition, it is fast enough.
This technique consists of several stages:
- Collection of biomaterial: it can be sputum, some blood, a few milliliters of gastric juice, water from the bronchus. Biological material can be completely different, it all depends on the type of pathogen.
- Then you need to destroy the DNA structure, which is primary. This is done in order to disconnect the circuits under the influence of high temperatures.
- The temperature decreases and the primer binds to the DNA strand.
- Then there is a process in which the desired molecules are synthesized.
The procedure takes approximately four to five hours.
Despite the fact that PCR is quite accurate and convenient, it is also distinguished by its high cost. State-level clinics do not always have such equipment.
Diagnostic methods that are considered primary in most cases fully justify themselves. They also include a blood test for tuberculosis in a child.
Where can such tests be done?
Of course, the question is brewing: where can one take such tests? For example, in almost every city there is an INVITRO laboratory that deals with this kind of analysis.
The quality here is considered international level, confirmed by certificates. Quality control takes place according to international rules that are accepted throughout Europe.
This laboratory is at the level of top international medical companies, which are the first in the world market. The laboratory is the leader in diagnostics in the country.
Going to the website of this company, you can see a photo with a building called the main office. Also there are prices for each analysis, as well as for a blood test on this topic.
As you can see, in addition to mantoux, you can do at least two procedures that are great for identifying a disease, or the body's ability to fight infection.
This is a kind of test of the body's abilities. Despite the fact that manta is considered a mandatory vaccination, now parents are looking for a lot of workarounds for various reasons: they are afraid for the body's reaction to manta, and they also just want a diagnosis that would be more accurate.
There is nothing to worry about, because the health and life of children should always come first. Therefore, it is possible to do a blood test for tuberculosis instead of a mantoux for a child, as well as a PCR diagnosis of tuberculosis, which can be used even by children.
Both differ from the mantoux in that they are more accurate. The advantage of these methods is that they can be used at any age, so this will not be a problem for children.
A blood test, of course, refers to a more general description of the state of the body and will provide an opportunity to examine it for various diseases, if the parent so desires.
To choose one or another method, of course, the parent. It will depend on the goals they are pursuing. If you just need a certificate for an educational institution, then a blood test will do.
But it may not be accurate if the child was given BCG. If you want to know the real results without the risk of lies, then PCR, although expensive.
But one should not deny that the health of the child is most important, first of all, you just need to pay attention and the first signs of the disease will never go unnoticed.
A small prick on the inside of the arm that cannot be wetted - everyone faced this in childhood in the school nurse's office. Someone calls the Mantoux test an analysis, someone calls it a vaccination, but both are wrong.
The Mantoux test, like a blood test (which is carried out separately and is more detailed) is a kind of test to identify people whose body got infected.
What is the name of the test that replaces Mantoux
The Mantoux reaction, also known as the Pirquet test, is carried out by the method of intradermal or cutaneous tests in order to detect tuberculin.
The reason for this is more than serious - in our country there is an increase in the number of tuberculosis patients. For every one hundred thousand people at eighty discovered this serious disease.
Despite the fact that medicine has long learned to deal with this formidable disease, mortality from it is still quite high. The key to successful treatment of any disease is its early detection. It is for this purpose that examinations are carried out from early childhood.
However, few people know that this method has its downsides. The fact is that the Mantoux test is positive not only in sick people, but also in healthy people who were once vaccinated against tuberculosis. It should be taken into account that today, due to mass vaccination, most children are vaccinated - accordingly, the result of the reaction will be positive. And for allergy sufferers, this method is a threat.
Alternative
Therefore, the question of alternative studies naturally arose. These include:
- analysis blood;
- quantiferon test;
They are resorted to in cases where the Mantoux reaction is suspicious (it turned out over 6 mm), or the person is sent to TB dispensary. They allow you to identify really sick with tuberculosis, without capturing those who have been vaccinated.
Photo 1. With a positive Mantoux test, other testing methods are resorted to to confirm the diagnosis.
mantoux
The reaction is a laboratory study that is carried out in all children whose age has stepped over the mark one year. It is an injection with a special tuberculin syringe, due to which many even adults mistakenly call it a vaccine. But this definition is incorrect, in the laboratory assistant's syringe is tuberculin. This substance, which includes parts of microbial cells, waste products of pathogens and particles of their environment.
The body responds unequivocally to any intervention - inflammation, this is a kind of signal that some kind of emergency situation has occurred. Accordingly, lymphocytes approach the site of intervention. It all depends on whether they recognize "aliens" or not. Particularly noticeable will be the cells that have already "communicated" with the pathogens of tuberculosis and the elements of its vital activity.
Important! Research needs to be done before staging any vaccinations, because any of them can make the test results unreliable.
If the Mantoux test is positive, and the inflammation will intensify - this is a sure indication that the body has "recognized" the aggressor. But this is not necessarily evidence that the patient is already sick. In the same way, the body reacts to the Mantoux test in people vaccinated against tuberculosis.
A study using the Mantoux reaction is performed in all children up to fourteen age. For the study, the patient must sit, not stand, the injection is made in the middle third of the forearm.
The injection is painless, almost instantaneous and almost imperceptible. In its place, a slight reddening appears, and the skin swells slightly (a papule is formed, which schoolchildren used to call a “button”).
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How to prepare for research?
To do this, you need to find out when the notorious "button" will be put in the kindergarten or school.
Behind three(preferably five) days before the planned testing, you need to remove from the diet all foods that provoke allergies. For example, honey, oranges, chocolate. The reason is that tuberculin can cause allergies even in those who have never complained of allergic manifestations before.
If the baby has already had a negative experience of the Mantoux test, associated specifically with allergies (an increase in papule), you can drink an antihistamine that suppresses allergies these days. It is best to consult with your doctor beforehand.
Important! At the time of testing, the person must be perfectly healthy!
This means not only that he is currently feeling quite well, he should remain so for at least two weeks before the proposed study. If there were any disorders (not even necessarily a cold or inflammation, but for example, food poisoning), the study must be rescheduled.
Photo 2. In case of a child’s illness (cold, runny nose), the Mantoux test must be transferred until recovery.
On the day of testing, the child must wear long sleeves. At the same time, the shirt or pullover in contact with the skin should not be synthetic or contain coarse fibers so that they do not irritate the injection site, which can already irritate. If the child could not resist and combed or forgot and eventually wet the wound, this is a must. tell the doctor.
Neither comb, nor be affected water the injection site is in no case impossible. No need to smear the wound by any means and seal it plaster. An exception is if suppuration has formed at the site of the Mantoux test. In this case, it is treated like a normal abrasion.
If all the rules were followed, and the reaction to the Mantoux test was positive - there is no need to be afraid, this does not mean that Koch's sticks appeared in the young body. This is just an excuse for another study, more detailed.
Carefully! There are a number of contraindications to the tuberculin test.
These include:
- exacerbation chronic diseases;
- allergy;
- Availability skin diseases;
- epilepsy.
The test results are checked for third day.
Blood test for tuberculosis instead of Mantoux test
It is carried out in district clinics, public and private medical centers. Usually the result is ready maximum after three days(in a private clinic they write a specific date in the price list).
To prepare for the analysis, you need to follow a few rules:
- Behind week before the planned blood draw completely eliminate from the diet of fatty, spicy foods, as well as alcohol.
- In the coming three or five days prior to the study, strong psychological shocks should be avoided.
- Not to drink antibiotics. If you have taken them some time ago, be sure to tell your doctor before the test.
- Blood test done early in the morning on an empty stomach(since the last meal, at least five hours).
The term "blood test" should be properly understood in this regard. It must be said that the very composition of the blood of an infected person does not change. For research, a laboratory assistant takes a blood sample into a test tube with an anticoagulant (a drug that prevents blood from clotting). After that, the plasma and cell sediment are separated. If there is an infection, then there is a change in the rate of sediment erythrocytes(in the patient it is increased). The norm is up to 10 mm/hour(men) and up to 15 mm/hour(women).
Also researched leukocytes. The normal formula is 5—12×10 (9). Indicators of patients, especially those suffering from exacerbations and severe forms of fibrous-cavernous tuberculosis, can be 12-15x10(9). Much attention is also given to the nuclear shift of neutrophils.
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