To this day, controversy continues among doctors and ordinary people whether a tuberculin test or Mantoux vaccination is harmful to a child. The harm of the test outweighs its diagnostic benefit for parents. The fact is that sometimes as a result of manipulations, children develop side effects that negatively affect their health. What are the most common complications after Mantoux? Why does this happen, and is it worth abandoning the test in favor of other methods for identifying Koch’s bacillus?
X-ray or manta for children: what to do, which is more harmful?
Few young children enjoy the Mantoux test, or any injections. And parents are worried that the Mantoux test can infect their child with tuberculosis, since the drug uses a strain of this disease. In fact, the Mantoux test is a non-living mycobacterium tuberculosis that cannot infect the body, but will provoke a reaction if infected. On the other hand, when deciding which is more harmful, Mantoux or x-rays, it is worth knowing that the reaction to tuberculin contained in the preparation for the Mantoux test may be different for each child. Often the reason for refusing it is an allergic reaction to the drug or individual intolerance.
If parents refuse the test
If parents decide not to give their child a tuberculin test, this will not cause unpleasant consequences. In accordance with Law No. 77 of June 18, 2001 “On preventing the spread of tuberculosis in the Russian Federation,” the Mantoux test is carried out only with the consent of citizens. However, by refusing state anti-tuberculosis support, parents deprive their child of early diagnosis opportunities.
Why some parents are inclined to refuse the test
One of the reasons for refusing Mantoux is the belief in the toxicity of the drug containing phenol. Other citizens view tuberculin as a source of bacteria.
Considering phenol as a toxic substance, many forget that it is produced by the body itself and breaks down into completely safe substances. Moreover, phenol is present even in everyone’s favorite smoked meats, which no one considers poisonous. When refusing a test, you should take into account the opinion of experts who provide the following data: one dose of the vaccine contains only 0.001 mg of a preservative (phenol), which will not cause any harm to the body.
When performing a Mantoux test, tuberculin is injected - an extract from killed particles of tuberculous mycobacteria treated by chemical and thermal methods. Therefore, this drug should not be considered as a probable source of infection.
What happens if you don’t give Mantoux to a child?
The drug is administered subcutaneously in an insignificant dose, and the body reacts after the test by forming a “button” - a small seal that is the epicenter of the allergic reaction. The type and size of the papule allows you to solve two problems at once:
- determining the presence of immunity and its level;
- detection of possible infections that occurred during the year.
The Mantoux test, as a research method, is a simple and effective way to detect the activity of tuberculous mycobacteria in the body. The earlier the infection is detected, the greater the chances of a full recovery in the future. Experts strongly convey to parents the idea: if you do not give Mantoux to your child, you will expose him to a high risk of becoming infected. After all, children are constantly in large groups: in schools, kindergartens, sports clubs, clubs, where there is a high probability of the spread of a dangerous disease. If the disease is not detected in the early stages, it subsequently implies long-term treatment of tuberculosis, complications and a decrease in the quality of life.
Tuberculin test: is it necessary to do?
Many parents who have not yet thought about what is safer for the child, Mantoux or X-ray, mistakenly take the test for a vaccination against tuberculosis, but the situation is different. During the Mantoux test, the child is injected with waste products of Koch's bacillus, the causative agent of tuberculosis, in a weakened form. Then, over the course of several days, the body’s immune system’s response to the invasion of the tuberculosis pathogen is assessed. An absent or insignificant reaction indicates that the child is not infected with tuberculosis. Therefore, in reality, a tuberculin test is not necessary if another diagnostic method has been chosen.
Mantoux: is it necessary to do a sample?
Whether to give Mantoux to a child is the choice of every parent. This is not a forced event, but a forced preventive measure related to the difficult epidemiological situation regarding the incidence of tuberculosis in Russia. It is necessary for early detection of the activity of a dangerous infection in the body in case of infection and assessment of the effectiveness of vaccination. Whether Mantoux vaccination is considered mandatory or not for a child is decided only by his parents.
The test tests the response of the immune system to the introduction of tuberculin, an extract from tuberculosis mycobacteria cultivated in an artificially reconstituted nutrient medium. If the Mantoux reaction has pronounced manifestations, then we can assume the presence of a Koch bacillus.
Tuberculin extract causes an allergic reaction, indicating the presence or absence of a tuberculosis pathogen in a child, the degree of “familiarity” of immune memory cells with this antigen.
Is it necessary to do Mantu when enrolling a child in an educational institution? On the one hand, vaccination and various diagnostic methods are not mandatory by law. This means that you can refuse them. But it should be borne in mind that the absence of records of mandatory vaccinations and medical tests in a small patient’s card or refusal to do so can cause unpleasant consequences for both the student and his parents:
- difficulties with registration at an educational institution;
- The Mantoux test helps in early detection of the disease when there are no symptoms yet. If you don’t do it, you can miss the onset of the disease;
- Without a certificate of completion of a mandatory medical examination, travel of a child with his parents abroad is doubtful;
- an adult may be suspended from work or denied employment if he does not have a certificate of absence of lung disease. It is issued based on the results of annual fluorography.
The choice of whether to carry out Mantoux or refuse is a free decision of every citizen of the Russian Federation.
Mantoux test: advantages and disadvantages
The main advantage of the Mantoux test, known since childhood, is its high diagnostic information content, general availability and low cost. However, those who cannot decide what is more harmful for a child, Mantoux or X-rays, should know that the test is mandatory by law for all children once a year. Any parent has the right to refuse the Mantoux test by completing the appropriate documents. In addition, the procedure has disadvantages. If the medical staff is incompetent, the reaction may be false positive, for example, due to an incorrect sample or within a short period of time after BCG vaccination. False-positive results are also possible in children with reduced immunity or a tendency to allergic reactions.
Radiography: advantages and disadvantages
Radiography is used to diagnose tuberculosis mainly in adults and has advantages. This is a non-invasive diagnostic method, quick and accessible, it allows you to identify not only tuberculosis, but also its stage. However, according to the letter of the law, which long ago “decided” which is less harmful, Mantoux or X-ray, prescribe an X-ray examination
Instead of a mandatory test, no doctor has the right. Therefore, doctors refuse parents’ unreasonable requests to replace Mantoux with x-rays. X-rays, which are seen by legislative bodies as more harmful, are prescribed either after a positive result of the Mantoux test, or after positive test results for the presence of tuberculosis bacillus. It's all about the radiation that the body receives during an X-ray examination.
Harm from radiation to a child
When deciding what is better for a child, Mantoux or an x-ray, you should first consider the harm from radiation to the child’s body. X-ray of the lungs and fluorography
cover a significant part of the child’s body and create a significant radiation dose compared to other types of x-rays. During the period of growth, a child’s body is vulnerable to radiation, which affects health at the genetic level by transforming DNA. For children under one year old, x-rays are replaced by other research methods. Therefore, X-rays are prescribed to children in the most extreme cases by a TB doctor, when serious lung diseases are diagnosed and the harm from them is much greater than the negative effects of X-rays.
What is better to do, X-ray or Mantoux, for a child?
If the child’s body’s reaction to the Mantoux test is adequate, it is better to use this safe and effective diagnostic method. If, due to an allergic reaction or individual intolerance to tuberculin, the Mantoux test is contraindicated, you should know that an x-ray will not be much more harmful. If there is an urgent need, it can be done or preference can be given to alternative diagnostic methods.
Why is it still recommended to undergo diagnostics?
If a child shows signs indicating a possible tuberculosis infection, you should immediately consult a doctor and take Mantoux. Fluorography for minors is allowed in rare critical cases, so the tuberculin test is the only source of information for making a preliminary diagnosis.
Unscheduled diagnosis using the Mantoux method is recommended in the following cases:
- if there are many infected people in the region of residence, the procedure is mandatory;
- sanitary conditions at the place of residence are considered unfavorable;
- Mantoux should definitely be given if there is constant contact with tuberculosis patients;
- living in a densely populated area, where unintentional infection is likely in retail outlets, transport, or work;
- lack of adequate nutrition;
- weakened immunity due to illness.
If the test shows a positive result, the TB doctor prescribes an additional comprehensive examination to clarify the diagnosis.
Why is it worth making Mantu every year?
High living density, as well as lack of public awareness, create favorable conditions for the spread of a dangerous disease. Tuberculosis bacilli, spread by airborne droplets, can survive up to 2 weeks outside a living organism. To destroy them, it is necessary to treat them with special compounds. This is rarely done in schools, kindergartens, public transport, not to mention shops and playgrounds.
Prevention of tuberculosis is supported at the state level. Within its framework the following are provided:
- three-stage BCG vaccination: per year, at 7 years and at 14 years;
- monitoring the state of formed immunity. It is the introduction of tuberculin (Mantoux test) that is the tool for such control. Starting from 12 months, Mantu is done every year. This regularity allows you to take timely measures if vaccination does not have an effect. In addition, this makes it easier to find signs of the disease and stop its development if infection does occur.
You need to make Manta every year until you are 14 years old. The last routine check is done before the third BCG vaccination. If you do not test annually, you may miss the onset of a serious illness.
Alternative methods for diagnosing tuberculosis
There is no need to guess what is more harmful, Mantoux or X-ray, since modern medicine makes it possible to diagnose tuberculosis in other ways. In difficult cases, doctors often offer alternative methods for diagnosing tuberculosis.
Diaskintest
Diaskin is the newest drug for diagnosing tuberculosis. Its difference from the Mantoux test is that it does not depend on BCG vaccination and, therefore, gives more accurate results - up to 90%. The secret is that the drug for Diaskintest contains two antigens that are present in the tuberculosis strain, but are absent in the BCG vaccine. On the other hand, the lack of response to BCG makes Diaskintest completely useless for determining indications for revaccination. Therefore, at 7 and 14 years old you will still have to do a Mantoux test. If the Diaskin test is included in the compulsory medical insurance of your region, you can do it for free.
PCR diagnostics
Polymerase chain reaction is the most accurate method for diagnosing any infection. Those who have not yet decided which is more dangerous, Mantoux or X-ray, should keep this method of laboratory diagnostics in mind. All that is required for PCR is to provide biological material; there will be no allergic or other reactions. Moreover, PCR is a very accurate analysis that can detect DNA and RNA of any pathogen. However, this test can only be accurate for those children who have not had tuberculosis, since remaining inactive DNA and RNA from the pathogen can make the test false positive. Compulsory medical insurance conditions vary in different regions of Russia, so PCR analysis can be either paid or free.
