Should my child have a diaskintest? Diaskintest - what does it show? Indications, side effects, preparation and conduct of the test for children and adults, results (photos of positive and negative reactions, norm), reviews. Where to do it? Comparison with the Mantoux test.

Diaskintest (d test) was invented in 2009 at the Sechenov Moscow Aviation Institute. The development was aimed at increasing the accuracy of diagnosing tuberculosis in children and adults in the early stages. Today the drug is publicly available and shows the highest accuracy of the result compared to the outdated Mantoux test. What a d-test is and how it is used in children's institutions to monitor tuberculosis among children will be discussed further.

D test as a method for detecting disease

The drug contains a special allergenic protein that reacts to the presence of Koch bacillus bacteria in the human body. Unlike the Mantoux diagnosis, when you can perform a d test for tuberculosis, the results are more accurate. Only in rare cases does the allergen react to other infectious diseases or weakened immunity, giving a false positive reaction.

At the moment, there is no more accurate method for detecting tuberculosis in humans without additional research, using only medications.

Diaskintest is done similarly to the Mantoux test, but on the other hand. Three days after the test, the result is assessed by the rash that appears at the site of the Diaskintest injection (papule). The result is interpreted according to the size and shade of the rash. Until reaching adulthood, the test is carried out once every 2 years.

Mantoux test with diaskin

Diagnostics are carried out as planned, as in the case of the Mantoux test. The injection is placed in the less active hand (for right-handers in the left, for left-handers in the right) in the forearm area. In the event of an outbreak of the disease in the region where the diaskintest is performed, children may also be given a Mantoux test in the other arm so that the result is as accurate as possible. To carry out diagnostics, a special syringe with a very thin needle is used.

Minimize water treatments. Contact with water is not prohibited, but as a precaution, do not wet the rash.
Do not apply healing ointments, seal with a plaster or bandage an emerging papule.
Exclude from the child’s schedule physical activity and training that are accompanied by an increase in body temperature.
You should not send your child into the sun or frost until the result is assessed.

Indications for placing Diaskintest

Testing for the presence of tuberculosis disease using Diaskintest (DST test) is prescribed in the following cases:

Diagnosis of the disease, as well as stages of the disease in adults and children over 1 year of age;
Diaskintest detection of tuberculosis microbacteria against the background of other infectious diseases;
Diaskin can be administered to determine the accuracy of the response to the Mantoux test (the Mantoux allergen reacts positively in people vaccinated with BCG);
In the process of treating an already identified disease with the help of protein in the drug, the effectiveness of the prescribed therapy is assessed.

After testing, children who are identified or suspected of having one are sent to the phthisiology department for additional examinations.

The D-test shows a true result in 99% of cases and is one of the most effective methods of anti-tuberculosis control in Russia.

How to decipher the result

The results of the diaskintest should be assessed by a medical professional no earlier than 48 hours after the introduction of the allergen. The ideal time to check the result for the presence of tuberculosis infection is 72 hours (3 days). There are 4 options for assessing the rash at the injection site:

Negative.
Positive.
Doubtful.
Hyperergic.

In children's institutions, vaccine injections are carried out en masse according to the vaccination calendar. Depending on the type of reaction after the test, doctors are required to take the necessary measures.

Negative reaction

If a negative reaction to the diaskintest was detected, this means that the child is healthy. Redness up to 2 mm in diameter and a slight bruise after the injection are considered acceptable norms. Ideally, there should be no papules on the arm of a healthy child at all.

Questionable reaction (false positive)

This is how the result is assessed when the injected tuberculin showed a reaction with a diameter of up to 4 mm (in some cases, more). A questionable reaction is associated with the appearance of a papule, sometimes with enlarged lymph nodes in the neck and armpits. In any case, the child is prescribed additional tests. If the doctors did an x-ray and everything is fine, do not forget about what happened. In rare cases, Diaskin reacts to other acute infections in addition to the causative agent of tuberculosis, as well as to severely weakened human immunity. A full examination will be required to identify the reason why the allergen gave a false positive reaction.

Positive reaction

A positive diaskintest is said when the size of the papule reaches more than 7 mm in diameter. This reaction directly indicates the need for treatment of tuberculosis.

If the result is positive, children are hospitalized at a tuberculosis clinic, where an examination is carried out and the necessary treatment is prescribed.

Hyperergic reaction

The most dangerous reaction to Diaskintest. This reaction means that the child is infected and the disease is active. Anyone who has frequent contact with the sick person can become infected. With a hyperergic reaction, large redness of 10–14 mm and a pronounced papule of a rich shade are observed. In this case, the child is immediately hospitalized, X-rays, blood and urine tests are performed. All his relatives and people with whom the sick person was often in contact will have to undergo the examination.

Despite possible adverse reactions of the body in the form of a false result, the d test is the most accurate way to diagnose tuberculosis at any stage without radiation and complex medical procedures.

At the end of 2009, mass testing for tuberculosis began in Russia using the Diaskintest test as an alternative to Mantoux. In 2010, the whole country learned about what DST is.

At the moment, Diaskintest is used as an additional diagnostic for a positive Mantoux test, and also as an alternative to Mantoux for patients with intolerance to the composition of the test. So, Diaskintest: what is it?

Specifics of Diaskintest

The Diaskintest drug has a higher accuracy of results compared to the Mantoux test, because contains more specific proteins that react to the causative agent of tuberculosis - Koch's bacillus - and reduce the influence of allergy factors or the possibility of developing a spontaneous false-positive reaction.

So what is Diaskintest (DST)? Diaskintest is a study carried out using intradermal injection of the drug with subsequent assessment of the resulting papule.

This method is not grafting. Speaking about Diaskintest, you need to understand that this is only a diagnostic test, i.e. This drug does not protect the patient from the disease, but allows it to be detected. Like Mantoux, it follows the BCG vaccination no earlier than 2 months later.

The analysis of DST indicators is assessed according to the same scheme as the Mantoux test. A papule forms 72 hours after the injection and means a positive reaction to the test (infection). Normally, the papule should be absent or there should be a small (up to 1 mm) swelling at the site of the needle injection. The gradation of positive reaction indicators is the same as for Mantoux.

Diaskintest contains two types of recombinant proteins that are insensitive to bacteria that do not cause diseases. In addition, Diaskintest allows you to distinguish:

infection;
allergic reactions;
residual positive reactions after BCG vaccination.

The composition is safe for children, because does not contain live pathogens.

Indications for Diaskintest are:

increased sensitivity to tuberculin (congenital or acquired as a result of a booster effect);
any positive or hyperergic reactions;
"turns" of the sample.

Diaskintest allows you to separate false-positive test results from true positive ones due to the lack of sensitivity to allergy factors and third-party inflammatory processes.

Contraindications are chronic diseases during exacerbation or acute infectious diseases. You should also not do Daskintest if:

skin diseases:
exacerbations of allergic reactions;
epilepsy and;
quarantine in children's groups.

In case of exacerbation of diseases and in case of quarantine, it is necessary to first wait a month after complete recovery (or quarantine is lifted).

DST procedure

To prepare for Diaskintest, you should make sure that the child is healthy and does not experience allergy symptoms. To do this, you can contact your local pediatrician for an initial examination. You can limit yourself to measuring temperature and visually examining the throat, feeling the lymph nodes, but this will not give an accurate result. Such preparation is necessary in order not to aggravate the symptoms of a cold or allergy, because... The DST test still causes minor rejection in the body tissues, and it is better to anticipate possible side effects.

It is also necessary that no vaccinations are carried out before the Diaskintest test. For most vaccinations, the waiting period is 1 month; some complex vaccinations require no samples for 3-5 months.

The test is carried out using the same technology as the Mantoux reaction. The patient is in a sitting position, the forearm is bent, relaxed, and lies freely on the medical table. The injection should be made in the middle third of the forearm. The injection site is treated with an antiseptic solution and the drug is injected intradermally with a special needle. In this case, a thickening or papule visually forms in the skin, which subsequently disappears or forms into a denser formation within 72 hours.

The result is assessed using a transparent flexible ruler, which is placed across the forearm and the widest part of the papule is measured. A negative reaction is considered to be the presence of a thickening of about 1 mm, a doubtful reaction is the absence of a papule in the presence of hyperemia (severe redness), a positive reaction is the presence of a papule larger than the “prick reaction”.

There is also a hyperergic reaction - when the papule is more than 15 mm or contains vesicular-necrotic changes (severe inflammation, abscesses). If there is a doubtful, positive or hyperergic reaction, the patient is sent for additional examination to confirm (or refute) the diagnosis of tuberculosis.

Should DST be performed on an empty stomach or not? In fact, this measure is not justified in any way. Just on the eve of the procedure and before the test, you should not consume highly allergenic foods in order to avoid a skin reaction and the spread of the infiltrate. Such products include:

chocolate;
citrus;
strawberries;
sweets in large quantities.

Parents whose children are about to undergo the test should keep this in mind and adjust the child’s menu.

How often can Diaskintest be done? Children with BCG vaccination are given it at the same frequency as the Mantoux test - once a year. If necessary (if there was a negative test), it can be repeated after 2 months. In tuberculosis dispensaries, DST is performed every 3-6 months.

There are no restrictions regarding the Mantoux test; they can be alternated in any sequence and at any time interval. It is only necessary to fulfill the previously stated conditions regarding vaccination and infectious diseases.

Why do DST and what are the side effects?

Diaskintest is one of the most accurate methods for diagnosing tuberculosis.

Timely detection of infection allows you to:

cure the disease in the early stages;
avoid the spread of infection;
severe complications.

Unfortunately, tuberculosis is not the rarest disease, and you cannot insure yourself against contact with the pathogen. Infection is especially dangerous for children without BCG vaccination, because they have a much higher risk of contracting tuberculosis, and if treatment is not started in a timely manner, they have severe complications, including death.

During examination with Diaskin, infection cannot occur, because it does not contain tuberculosis pathogens.

Complications after injection may include the following:

increased body temperature;
malaise;
headache.

If after the test the child develops other symptoms (coughing, sneezing, runny nose), then this is not a consequence of the drug’s action - the child may have a cold.

Side effects can also include a hyperergic reaction, which, in addition, is a diagnostic sign. With a hyperergic reaction it is possible:

severe skin inflammation;
irritation;
the appearance of rashes, ulcers;
tissue death.

If such a reaction occurs, medical attention and urgent contact with a phthisiatrician are necessary, because it is most likely a sign of infection.

Other possible consequences of DST include an allergic reaction - a specific intolerance to the components of the drug.

If the patient has once been diagnosed with an allergy to the Diaskintest done, you should consult with your doctor about drawing up an individual regimen for taking antihistamines immediately before the test. Another option is to choose a different diagnostic method (Mantoux reaction, Pirquet test).

The injection site before the test (and even after) should not be scratched, rubbed, covered with patches or wrapped in bandages. This will distort the test results and damage the skin. In addition, the injection site should not be burned with brilliant green, iodine, alcohol, smeared with perfume, or steamed in hot water. It is allowed to wet your hand in warm water for a short time, but not in the first few hours after the injection.

Despite possible side effects, it is necessary to diagnose tuberculosis. If there are temporary contraindications, you should wait for a suitable period and conduct a test in a clinic at your place of residence; if there are permanent contraindications, you should look for an alternative diagnostic option. Tuberculosis is a disease that is dangerous not only for each individual, but also for society as a whole, and preventing the spread of infection is the duty of every person.

Until 2009, tuberculosis in children was detected only using the intradermal Mantoux reaction, until Russian scientists invented Diaskintest. In comparison with Mantoux, it not only detects the tuberculosis bacillus, but also determines the number of pathogens causing the infectious process. Diaskintest is not used instead of Mantoux, which often makes mistakes in the results, it is only an addition to it, and shows a positive result only if people are actually infected with tuberculosis.

What is Diaskintest?

The modern tuberculosis test is an additional method of diagnosing tuberculosis infection. The d-test includes a specific protein that causes an immune reaction only to the tuberculosis bacillus. Its advantage lies in the accuracy of the results, as well as the ability to distinguish between the form of human infection with tuberculosis in a person vaccinated with BCG, and with non-pathogenic mycobacteria. Due to its high sensitivity, it helps to assess the effectiveness of tuberculosis therapy and carry out preventive monitoring of all groups of people.

Diaskintest, by its mechanism of action, detects the response of immune cells to Mycobacterium tuberculosis. A specific skin reaction occurs that indicates hypersensitivity.

Diaskintest is a solution of recombinant protein from two antigens, which is administered by injection. The reaction is carried out inside the skin, in the area of the forearm of either hand, using a special tuberculin syringe with a thin needle. In some cases, doctors allow the Mantoux reaction and the d-test to be done at the same time on different hands. They go well together and complement each other.

IMPORTANT! With a positive Mantoux test and a negative Diaskintest test, good immunity and non-infection with Mycobacterium tuberculosis are determined.

Who created Diaskintest?

The creators of the drug were scientists - Vsevolod Ivanovich Kiselev, Mikhail Izrailevich Perelman, Mikhail Aleksandrovich Paltsev, who came up with a name for it from the Latin combination: “dia” - abbreviated diagnosis, and “skin” - skin, which together means skin diagnostic test.

The main advantage of Diaskintest, as a hypertest, according to scientists, is its ability to clarify the picture of the incidence of tuberculosis. When people have a negative answer after the test, it means that they are healthy! Thanks to the BCG vaccine, people are sensitive to the tuberculosis bacillus. The Mantoux test (made from tuberculin) determines the level of immunity, and not the degree of infection with mycobacteria. Diaskintest consists of protein molecules with clear characteristics that detect mycobacteria at stages when the disease does not manifest itself in any way, and which:

highly safe and specific;
in healthy people it always manifests itself as a negative reaction;
highly sensitive - people with tuberculosis always have a positive reaction to the test;
excellent control over the effectiveness of tuberculosis therapy.

Important! Some people think that Diaskintest is a vaccination and express their negative opinion on this matter. They must remember that the test is a test inside the skin that shows the body's response to tuberculosis. Many people are carriers of tuberculosis, so early detection of the infection helps prevent the onset of the disease. DST vaccination occurs only in the form of the introduction of a special protein, which does not pose any harm to the body and shows the state of the body’s immunity against Mycobacterium tuberculosis.

Main indications for the d-test

Diagnosis is carried out for all age groups as prescribed by a phthisiatrician. For patients with increased allergies, the test is carried out while taking desensitizing agents. The D-test itself does not cause allergies. A small hematoma may appear after the test, which is not dangerous and is considered normal.

Tuberculin diagnostics and diaskintest are different concepts even in chemical composition (the first is the introduction of tuberculin with Mantoux, the second is remontant protein).

Diaskintest is indicated for:

the first occurrence of a positive Mantoux reaction of more than 6 mm;
when there are frequent positive reactions to Mantoux tests for several years with a size of up to 12 mm or more;
low-grade fever that lasts a long time;
during pregnancy, if the doctor decides so;
frequent illnesses in children;
chronic pathologies in the body;
hyperergic reaction after Mantoux (17 mm or more).
preventive examinations of groups registered at the dispensary every 3-6 months.

A hyperergic reaction to a d-test is a positive result in which a large papule larger than 15 mm is formed, accompanied by an inflammatory reaction and irritation of the skin around it. The requirements for the diaskintest procedure are the same as for the Mantoux test - it is allowed to be carried out 1 month after vaccination.

Contraindications for the test

Diagnosis is not carried out in the following cases:

when a person comes into contact with tuberculosis patients;
there are skin diseases;
when there is an infectious disease, except in cases of suspected tuberculosis;
exacerbation of allergic diseases;
if the patient has epilepsy;
at high temperature;
exacerbation of somatic diseases;
quarantine of childhood infections;
when 1 month has not passed after a preventive vaccination of any plan.

Evaluation of test results

After the test, fill out all the necessary accounting documents and note the result. The test on the skin at the injection site forms a whitish papule resembling a lemon peel up to 10 mm in diameter. D - test can be carried out in kindergartens and schools, clinics and anti-tuberculosis dispensaries.

Diaskintest is checked for tuberculosis by a doctor or nurse by assessing the result on the third or fourth day after it is carried out. The assessment consists of measuring the skin reaction of the injection site using a transparent ruler. The resulting hyperemia and papule (infiltrate) are measured in the transverse axis using millimeters of a ruler. Diaskintest is allowed to be performed on all children from 8 to 17 years old once a year. For babies in the first year of life, the test is prescribed only after a positive result of the Mantoux reaction is obtained.

The norm for assessing the d-test is the absence of any pathological reaction to the injected protein solution: there should be no redness or the appearance of a papule. The first manifestations of drug administration appear after 6 hours. If the test is accompanied by a negative reaction, then a 1-2 mm hematoma may appear at the injection site.

The main points for assessing the test result are as follows:

A reaction after a test with a complete absence of redness and infiltration, or their presence with dimensions not exceeding 2 mm, is considered negative.
A reaction to a drug is called questionable if hyperemia without a papule is visible at the injection site.
A reaction is considered positive when there is an infiltrate of different sizes.
An infiltrate less than 5 mm in size is considered a mild reaction.
When the size of the infiltrate is in the range from 5 to 9 mm, the reaction is considered moderate.
A reaction with a papule size of 10 to 14 mm is called pronounced.
A hyperergic reaction is considered to be an infiltrate larger than 15 mm, accompanied by necrosis, lymphangitis and lymphadenitis.

If the result is negative, if necessary, the next test is recommended to be done only after 2 months, and after an acute infectious disease only after a month. All patients who are registered with a TB specialist are re-tested once every 3-6 months.

Sometimes a negative diaskintest result can occur in people who are not infected with tuberculosis, as well as in those who have gotten rid of it. A negative test result occurs when tuberculosis is inactive, as well as in patients during the recovery period after tuberculosis, with excellent X-ray, symptomatic and laboratory tests indicating an inactive process.

When there is a questionable and positive assessment of the diaskintest, the patient must be examined for Mycobacterium tuberculosis.

Diaskintest for tuberculosis, having specificity, does not show a reaction to vaccination with the BCG vaccine. There are strains of pathogens to which it also does not react in any way - these are mycobacteria, which are considered atypical. If a patient becomes ill with HIV infection, as well as with oncological processes, a false negative body test result will also appear.

IMPORTANT! The test does not cause complications or allergies. Very rarely, side effects may include slight fever, mild malaise or headaches, which are considered a normal reaction of the immune system to the introduction of protein.

There are rules that it is advisable to adhere to after Diaskintest:

You cannot apply any detergents, cosmetics, perfumes and medications (gels, ointments, sprays) to the injection site;
It is undesirable to comb and rub the test site;
no need to glue plasters and wrap bandages;
you can wash and wet your hands without using detergent at the injection site;
you can eat as usual.

If the above conditions are not met, reactionary redness occurs on the 1st day of the test, which affects the correct assessment of the results. Diaskintest for tuberculosis is very rarely erroneous, like most other methods in medicine, despite 100% accuracy and 80% sensitivity, in comparison with the Mantoux test, which has been used for the last 100 years. Diaskintest is the best modern diagnostic for identifying tuberculosis latency, which allows you to determine whether a person is infected with tuberculosis.

Tuberculosis outbreak prompts need for improvement diagnostics this insidious disease, which can be asymptomatic for a long time.

Along with traditional tests, new ones are used today innovative techniques that include Diaskintest.

Diaskintest was developed in MAI named after. Sechenov and after clinical trials is recognized as one of the leading methods for diagnosing tuberculosis

Diaskintest: what is it

Diaskintest allows you to determine the presence of an infectious process due to the body’s reaction to the introduction of special proteins, the carrier of which is Koch’s bacillus.

Scientifically speaking, this is recombinant allergen- a protein from a microorganism that causes disease. It contains two antigens.

They are not present in the substance used for BCG vaccination. The drug is diluted with isotonic phosphate solution before use.

It should be remembered that the drug contains phenol as a preservative.

Diaskintest is carried out in the form injections, which is placed in the thickness of the skin. A positive reaction in the form of skin manifestations will be noted when the person being examined is infected or already sick.

It is important that after therapy and recovery, if you have a BCG vaccination and immunity to Koch’s bacillus, the test will be negative. All this allows us to consider Diaskintest a reliable and effective method for detecting tuberculosis.

Comparison of skin test with Mantoux test

Before the advent of a new type of analysis, the Mantoux reaction was widespread in our country. Both tests are based on the appearance of a skin reaction. The installation method is also identical: it is injected into the dermis solution. However, there are also significant differences.

The main active ingredient used in the Mantoux reaction is tuberculin, a protein characteristic not only of Koch’s bacillus. It is found in a number of related microorganisms that are not capable of causing disease, and is also part of the preparation for BCG vaccinations.

Therefore, a positive reaction after performing the Mantoux test can be observed not only in the presence of the disease.

It simply indicates that the body has already dealt with tuberculin.

This happens in cases where:

passed short term from the time of vaccination;
was contact with infected people people;
available non-pathogenic microorganisms, related to Koch's wand.

Skintest includes synthetically created ESAT6/CFP10 proteins, characteristic of the causative agents of tuberculosis. Accordingly, its administration makes it possible to identify with high reliability whether the body is specifically familiar with Koch’s bacillus, and also gives an accurate answer whether a person is infected or sick. In this case no chance of false positive reactions, as in the case of Mantoux.

Pros of the D-test

Advantages of Diaskintest:

it is highly sensitive and 90% of cases gives an accurate answer to the question of whether a person is a carrier of pathogenic microorganisms;
give a chance distinguish infection of the body from conditions after vaccination and carriage of non-pathogenic related microflora;
allows monitor the effectiveness of treatment tuberculosis.

Important! Administration of the drug can't call infection and development of the tuberculosis process either in the absence of pathology before, or in the case of carriage, since does not contain living microorganisms.

When is it necessary to do a di-test for tuberculosis?

Despite high cost Diaskintest, this technique is considered more preferable due to its information content. Diskintest should be carried out if:

received positive the result of the Mantoux reaction;
preventive actions are needed aimed at identifying sick people among children from 1 year to 16 years;
available contact with sick people tuberculosis;
required diagnostics disease and assessment of the activity of its course;
need to be determined end of therapy.

Individuals at high risk should prefer this type of study. Experts recommend choosing Diaskintest when conducting diagnostic activities among children due to its high information content. At the same time, the doctor may prescribe X-ray examinations.

How is DST carried out?

With Diaskintest, the drug is administered subcutaneously with a special tuberculin syringe and a needle with an oblique cut. Only use a solution that has not expired. The sample requires 0.2 ml of the drug.

Photo 1. The injection is injected into the upper part of the forearm, intradermally, 0.2 ml of the drug is used.

Algorithm of actions when performing Diaskintest:

drawn into the syringe 0.2 ml;
0.1 ml descends before insertion into a cotton swab;
patient sits down on a chair;
freed up upper forearm;
area of the middle part of the forearm treated with alcohol;
skin stretches intradermally the solution is injected.

Normally, after Diaskintest, a papule in the form of a lemon peel the size of 7-10 mm.

Important! For nonspecific allergic reactions, you must first take desensitizing means.

Between samples there should be from 2 to 6 months. You should also observe a one-month gap between vaccinations and the testing event.

Decoding the DST test result

A medical worker evaluates the result of the DI test and checks in 48-72 hours after administration of the drug. For this purpose it is used ruler.

With its help, a medical professional measures the size of the skin change that appears. Place it transversely to the forearm.

The result could be:

negative;
positive;
doubtful;
hypergic.

What does normal look like?

If the result is negative, there are no redness or swelling at the injection site (or their size does not exceed 2 mm). A puncture bruise is allowed. If the reaction is positive, redness and swelling with a diameter of from 5 mm. If the stain less than 5 mm but more than 2 mm, speak of a weak positive reaction.

Questionable result

In doubtful cases, reddish manifestations of length are possible in the desired location. 2-4 mm. Sometimes after Diaskintest an unusual hypergic reaction is detected with the formation of large compactions with a diameter 14 mm and more, ulcers, blisters. The lymph node in the armpit or elbow may become enlarged.

Important! In all cases except a negative patient, the patient is referred to additional examinations and registration.

The reaction is growing within 3 days after administration of the drug. If you evaluate the result later than 72 hours, it will no longer be informative, so you need to contact a specialist to decipher it exactly at the specified time. You shouldn't do this yourself.

Photo 2. This is what a positive Diaskintest result looks like. After two months, a repeat test should be done.

In such cases, the person receives a referral to a tuberculosis clinic, where he is registered. A number of studies are being carried out. It is possible to prescribe medications. A repeat test is done 2 months later. If the result is negative, the person is removed from the register.

Is preparation required for the study?

There is no special preparation for Diaskintest, but it is recommended to visit a therapist to identify contraindications at the time of the test. If they are detected, you will have to undergo treatment for aggravated diseases.

Lifestyle restrictions

The results of Diaskintest are not affected by nutrition and water ingress at the injection site (unlike the Mantoux reaction). Therefore, theoretically can be wetted. The only exception is sensitive and allergic skin. In this case, you should protect the injection site from water.

The only thing that experts warn against is getting drugs at the injection site. household chemicals.

This can lead to itching and staining, so washing with soap and shower gels should be avoided for a while. There is no need to be afraid of accidental ingress of water.

To diagnose tuberculosis in children, tests with allergens isolated from pathogens are used. Intradermal administration of antigens causes a local reaction in a sick or infected person. Conducting a test for tuberculosis using Diaskintest is preferable to the well-known Mantoux test. The defining disadvantage of the latter is the low specificity of the reaction.. Diaskintest normally does not lead to any changes at the injection site in children. This is a more accurate test option that gives reactions only in the presence of an active tuberculosis infection. The disadvantages of the drug include a possible negative effect on the child’s immune system and the presence of toxic substances in the composition.

Indications for performing diaskintest

Tuberculosis testing is organized annually among children and adults. It includes immunological and radiological methods. From the age of 15, fluorography is used as a method for detecting tuberculosis. Answer to the question: « At what age is X-ray examination performed?"can only be given conditionally. X-rays may be needed at any age if tuberculosis cannot be ruled out.

Children up to the age of fifteen are tested annually using the Mantoux test, Diaskintest or other tests. Many people are interested in, at what age are tuberculin tests done? They begin at one year of age.

Indications for immunological research are not only preventive examinations, but also other purposes:

diagnosis of tuberculosis;
determination of process activity in tuberculosis;
assessment of the effectiveness of chemotherapy;
differential diagnosis of allergic reactions due to BCG vaccination or an infectious process caused by mycobacteria.

The difference between the Mantoux test and the use of Diaskintest

The main difference between Diaskintest and Mantoux is the specific antigenic composition of the drugs. The first test contains synthetic antigens that ensure the specificity of the reaction. The test results are not affected by BCG vaccination, since Diaskintest antigens are absent in the strains of microorganisms used in the manufacture of the vaccine. For Mantoux, a drug containing allergens of natural origin is used, including those similar to those contained in the BCG vaccine. This reason is considered the main reason why the Mantoux test gives a pronounced reaction in BCG vaccinated people. In addition, false positive results in healthy people after Mantoux are much more common than after Diaskintest. Most parents are attracted by the opportunity to give their child a test with a low probability of erroneous allergic reactions.

Comparison of the accuracy of the results of two types of testing in most cases shows that the Diaskintest is more informative. According to the results of one study of the use of the drug, its accuracy was 90%, and the Mantoux test was approximately 50–70%. Therefore, in recent years, new tests for tuberculosis, including Diaskintest, are replacing the outdated version of the study.

Video

Video - why is Diaskintest dangerous?

Contraindications for drug administration

Most babies are tested annually. Tuberculosis is a serious infection,
the effectiveness of treatment depends on the timely detection of pathology. In addition, the disease is contagious, and mass preventive examinations can reduce the spread of infection and reduce the incidence of this most dangerous disease. Based on the test results, a change in the tuberculin test or tuberculosis is detected. But in some cases the test is not performed.

First of all, parents have the right to decide whether to give their child a test in general and with this drug in particular. In addition, there are situations when the Diaskintest should be abandoned.

When performing the Diaskintest test, contraindications include the following pathologies:

acute diseases, including respiratory infections;
exacerbation of chronic pathologies, except in cases where it is necessary to exclude tuberculosis;
common skin diseases;
exacerbation of allergic diseases;
quarantine for childhood infection in a team;
epilepsy;
allergy to Diaskintest.

A temporary contraindication for the test is vaccination. You can do the test a month after vaccination or, preferably, schedule vaccination for a later period.

To the question “Is it possible to do Diaskintest with a runny nose?” should be answered in the negative. The presence of an acute infection may distort the test results. If your child has runny nose or other symptoms associated with rhinitis, you must wait until the cold is completely cured. Experts recommend waiting at least a month after the signs of the disease disappear, then you can do the Diaskintest, avoiding excessive inflammatory reactions during the test.

Setting up an immunological test

Diaskintest in a child is done similarly to the Mantoux test. The drug is administered intradermally, and after 3 days
The local reaction of Diaskintest is determined. Parents should know at what age the test starts. The first examination is performed on a child at one year of age.. Then it is repeated annually. But sometimes it is necessary to repeat the test over a short period of time. The subsequent tuberculin test is performed on the other forearm, maintaining the correct alternation in the future.

Diaskintest is an immunological drug that can cause a significant allergic reaction in a sensitized organism. Therefore, the natural question is how often you can do the test. The recommended time between two tests is at least 2 months. Studies have shown that this can reduce the burden on the child's immune system and minimize the possibility of side effects.

Sequence of actions when performing a sample:

Before administering the drug, the skin area is treated with alcohol;
the skin of the inner zone of the forearm at the level of the middle third is slightly stretched;
0.1 ml of Diaskintest is injected into the upper layers of the skin parallel to its surface;
the result of the injection will be a small whitish papule with a diameter of 5 mm.

After the test, redness may occur on the first day, but the results of the diaskintest in children are assessed not by day, but 72 hours after the injection. The test response is described as positive, negative or equivocal.

Evaluation of sample results

After 3 days, the size of the papule is measured; only if it is present, the child’s test result is positive. Pay attention to hyperemia only if there is no infiltration. The measurement is carried out with a transparent ruler, measuring the transverse (relative to the axis of the forearm) diameter of the papule or redness.

Evaluation of the results allows us to identify children who need further examination:

A positive diaskintest suggests the presence of a lump after injection, the size of which determines the severity of the reaction.
The test is considered doubtful if there is only redness.
Negative test results are normal for a child. In this case, there is no papule or hyperemia; only a reaction from an injection of no more than 2 mm can be observed.

When performing a Diaskintest test, a positive result can appear in the form of a weak (papule up to 5 mm), moderately expressed (up to 9 mm), pronounced (up to 14 mm) and hyperergic reaction. The latter indicates a pronounced immune reaction of the body and can signal danger to the body. What does a hyperergic reaction look like in a child?? Papule 15 mm or more, presence of vesicle, necrosis, lymphangitis after diaskintest.

Adverse reactions from the test

In some cases, a bruise is visible at the injection site. Rare side effects: headache, weakness, increased body temperature. Hematoma at the injection site is usually associated with improper injection technique, but it may mask the actual test results. Therefore, in such a situation, it is often necessary to do the Diaskintest again after 2 months.

Why is Diaskintest dangerous?? First of all, the possibility of allergic reactions to one of the components. In addition to antigens, the composition includes phenol, polysorbate, sodium and potassium salts. To prevent allergies, sometimes doctors recommend taking desensitizing medications a few days before the test. In addition, there are studies indicating a negative effect of the test on the immune system, which can lead to various health problems.

Actions in case of a positive test result

If a papule is detected at the site of injection of the recombinant tuberculosis allergen, do not despair. The final results will be summed up after additional examination. Despite the high information content of the test, the possibility of a false positive result or an allergic reaction to the components of the drug exists.

The examination will allow you to determine the real situation and choose tactics, what to do next: is it necessary to treat tuberculosis, take preventive chemotherapy, or the child is healthy and does not need therapy.