ACCURACY OF BCG TEST WITH TUBERCULIN TEST IN THE DIAGNOSIS OF EXTRA PULMONARY TUBERCULOSIS

Abstract

Objective: To determine the accuracy of BCG test with Tuberculin test in the diagnosis of extra pulmonary tuberculosis. Material and Methods; A total of 369 patients aged less than 18 years were taken. All the patients presenting in the pediatric medicine department Nishter hospital Multan, Pakistan fulfilling the inclusion and exclusion criteria were taken for this cross-sectional study. Modified Kenneth Jones scoring criteria (MKJSC) /Pakistan Pediatric Association (PPA) scoring chart was applied to all the patients. The investigations including CBC, ESR, chest X-ray, X-ray spine/joints, CT scan were obtained from central laboratory Nishter hospital, Multan. Tuberculin test and BCG test were performed simultaneously on the same patient and interpreted according to predefined criteria. Results; Of these 369 study cases, 192 (52%) were boys and 177 (48%) were girls. Mean age of our study cases was 6.24 ± 2.52 years (with minimum age was 2 years and maximum age was 12 years). Majority of our study cases i.e. 205 (55.6%) presented within 45 days of the symptoms of the disease. Mean disease duration was 47.89 ± 17.78 days (with minimum disease duration was 25 days and 90 days was maximum disease duration). Mean modified Kenneth Jones Scoring Criteria (MKJSC) 7.56 ± 0.754 in our study cases. Tuberculin test was positive in 219 (59.3 %) of our study cases, while BCG test positive in 272 (73.7%) of our study cases and accuracy of BCG test with tuberculin test was seen in 191 (51.8%) of our study cases. Stratification was done with regards to age, gender and disease duration and p-values were found to be p=0.000, p = 0.000 and p = 0.038. Conclusion; Our study results have indicated that BCG test is robust and safe test for the diagnosis of extrapulmonary tuberculosis in children of any age group. If applied simultaneously, they are useful diagnostic tool for the diagnosis of extra pulmonary TB.

Keywords; BCG Test, Tuberculin test, Extra pulmonary TB