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Guidance for National Tuberculosis Programmes on the Management of Tuberculosis in Children. 2nd edition. Geneva: World Health Organization; 2014. Guidance for National Tuberculosis Programmes on the Management of Tuberculosis in Children. 2nd edition.Show details
Annex 3Administering, reading and interpreting a tuberculin skin testThis annex gives information on administering, reading and interpreting a tuberculin skin test (TST). A TST is the intradermal injection of a combination of mycobacterial antigens that elicit an immune response (delayed-type hypersensitivity), represented by induration, which can be measured in millimetres. The standard method of identifying people infected with M. tuberculosis is the TST using the Mantoux method. Multiple puncture tests should not be used as these tests are unreliable (because the amount of tuberculin injected intradermally cannot be precisely controlled). This annex describes how to administer, read and interpret a TST using 5 tuberculin units (TU) of tuberculin PPD-S. An alternative to 5 TU of tuberculin PPD-S is 2 TU of tuberculin PPD RT 23. Administration
Figure A3.1Administration of the tuberculin skin test using the Mantoux method. The results should be read between 48 and 72 hours after administration. A patient who does not return within 72 hours will probably need to be rescheduled for another TST.
InterpretationInterpretation of TST depends on two factors: –diameter of the induration; –person's risk of being infected with TB and of progression to disease if infected. Induration of diameter ≥5 mm is considered positive in: –HIV-positive children; –severely malnourished children (with clinical evidence of marasmus or kwashiorkor). Induration of diameter ≥10 mm is considered positive in: –all other children (whether or not they have received BCG vaccination). Causes of false-negative and false-positive TSTs are listed in Table A3.1. Table A3.1Causes of false-negative and false-positive tuberculin skin tests. References1.Guidance for national tuberculosis programmes on the management of tuberculosis in children. Geneva: World Health Organization; 2006. (WHO/HTM/TB/2006.371) [PubMed: 17044200] Copyright © World Health Organization 2014. All rights reserved. Publications of the World Health Organization are available on the WHO website (www.who.int) or can be purchased from WHO Press, World Health Organization, 20 Avenue Appia, 1211 Geneva 27, Switzerland (tel.: +41 22 791 3264; fax: +41 22 791 4857; e-mail: tni.ohw@sredrokoob). Requests for permission to reproduce or translate WHO publications –whether for sale or for non-commercial distribution– should be addressed to WHO Press through the WHO website (www.who.int/about/licensing/copyright_form/en/index.html). Bookshelf ID: NBK214439 Which clinical manifestations are appropriate to identify in a child that indicates the need for an adenoidectomy?Your child's doctor may suggest that the adenoids be removed if: The adenoids are enlarged and are blocking the nose. Signs of a blocked airway include snoring, trouble breathing through the nose, breathing with the mouth open or times when the child stops breathing during sleep (sleep apnea).
Which intervention would the nurse perform when caring for an infant with RSV infection?Nursing interventions for a child with RSV are: Use of humidified air. Keep the room warm but not overheated; if the air is dry, a cool-mist humidifier or vaporizer can moisten the air and help ease congestion and coughing; be sure to keep the humidifier clean to prevent the growth of bacteria and molds.
Which symptom would the nurse expect to find in a child with acute Laryngotracheobronchitis?What is croup? Croup—also known as acute laryngotracheobronchitis—is an upper respiratory condition that often affects infants and young children. Typical symptoms in affected patients include a barking cough and respiratory distress.
Which is the first line of treatment for the child with epiglottitis and severe respiratory distress?The first priority in treating epiglottitis is ensuring that you or your child is receiving enough air. This may mean: Wearing a mask. The mask delivers oxygen to the lungs.
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