Utility of the Mantoux Test in the Diagnosis of Tuberculosis in Pediatric Population of a Tertiary Care Hospital, Patna

Abstract

Background: Tuberculosis (TB) is a serious public health concern, particularly in children, where identification is sometimes difficult
due to vague symptoms and paucibacillary illness. The Mantoux test (tuberculin skin test) is still commonly used as a screening tool,
particularly in resource-limited situations.
Objective: To assess the diagnostic usefulness of the Mantoux test in detecting tuberculosis in children at a tertiary care hospital.
Methods: Prospective observational research was carried out on 150 paediatric patients suspected of tuberculosis. Mantoux testing
was performed for all patients. Clinical, radiological, and microbiological findings were obtained. The diagnosis was established either
by microbiological confirmation of Mycobacterium tuberculosis or by a composite clinical diagnosis based on compatible clinical
features, radiological findings and the treating physician’s assessment, as per NTEP guidelines. Diagnostic characteristics such as
sensitivity, specificity, and predictive values were measured.
Results: Out of 150 paediatric patients, 95 (63.3%) were Mantoux-positive and 55 (36.7%) were Mantoux-negative. Among the
Mantoux-positive children, 75 were confirmed to have TB according to the predefined diagnostic criteria. while 20 were TB-negative.
Among the Mantoux-negative children, 15 were confirmed TB cases and 40 were TB-negative. The Mantoux test demonstrated a
sensitivity of 83.3% and a specificity of 66.7%, with a positive predictive value (PPV) of 78.9% and a negative predictive value (NPV)
of 72.7%. A positive Mantoux test was significantly associated with confirmed tuberculosis (p < 0.001).
Conclusion: The Mantoux test remains a helpful diagnostic tool in paediatric tuberculosis, although it should be used in conjunction
with clinical and radiographic findings.