What is the Diaskintest test and how are the test results evaluated? Diaskintest results: normal, positive, negative Diaskin test checking results after treatment

A drug called Diaskintest is used in the diagnosis of tuberculosis. It is used to perform a skin test, which can confirm the carriage of mycobacteria or active tuberculosis. It is often used as an alternative to the Mantoux test or to clarify its results.

Dosage form and composition

"Diaskintest" is a solution that must be administered intradermally. It is in a glass bottle of 3 ml, and one box contains 1, 5 or 10 bottles. The medicine itself is transparent, without any coloring.

The solution contains a recombinant protein that contains two antigens. This protein is obtained using modified E. coli, then diluted with a special buffer solution, to which a preservative (phenol) is added.

In addition, the preparation contains sodium chloride, sterile water and polysorbate 80, as well as sodium and potassium phosphate. The amount of active component in one dose of Diaskintest is 0.2 mcg. In this case, one dose is 0.1 ml, that is, one bottle contains 30 doses.

The test is done only in a medical institution, for example, in a municipal clinic, private medical center or an anti-tuberculosis dispensary. The drug from an opened bottle should be used within two hours.

The shelf life of Diaskintest is 2 years, and the solution should be stored at a temperature of +2-+8 degrees.

How does it work?

The protein present in Diaskintest is a tuberculosis allergen. The antigens it contains are found in pathogenic mycobacteria that cause tuberculosis. Thanks to such ingredients, an injection with a solution helps to identify the immune response to the tuberculosis pathogen.

After injection into the skin of a child infected with mycobacteria or suffering from tuberculosis, a specific reaction occurs. It is classified as delayed-type hypersensitivity. If the body is already “familiar” with mycobacteria, then the production of antibodies begins, which leads to the appearance of a small compaction (called a papule or infiltrate) or redness.

Since the drug does not contain the pathogen itself, but only proteins isolated from mycobacteria, it is impossible to become infected with tuberculosis due to Diaskintest. In this regard, the solution is not at all dangerous.

Test accuracy

The sensitivity of the test is estimated at 78–96%, that is, in the presence of tuberculosis in 4–12% of patients, the test may be false negative. Most often this is due to immunodeficiency conditions, when immune cells do not respond to the introduced allergen.

As for the specificity of the method, it is about 99%. This means that false positive results occur in approximately 1% of subjects. They are caused by a reaction to other types of mycobacteria that are not related to the causative agents of tuberculosis infection, which may be present in the body.

When is it used?

• if there is a suspicion of tuberculosis (there are clinical symptoms) or there is a high risk of its development (there was contact with a patient with an open form);
• if the child had a Mantoux test done at school, it turned out to be positive, but there are doubts that this is an allergic reaction to BCG or to the components of the solution;
• If little patient received a course of treatment against tuberculosis and needs to determine how effective it was.

Since the use of Diaskintest is unable to confirm immunity to tuberculosis developed after BCG, such a test cannot be used to select children who need revaccination. This is how Diaskintest differs from the Mantoux test, which is used to confirm immunity to tuberculosis. For this reason, it is not worth replacing Mantu with Diaskintest.

For a more accurate diagnosis, it is recommended to combine such tests.

In addition, Mantoux shows tuberculosis on early stage, but a test with Diaskintest cannot do this. And therefore, in situations where Mantoux turned out to be positive, but the Diaskintest done after it did not give a positive reaction, it is recommended to do another test after 2 months so as not to miss the onset of the infectious process.

Contraindications

"Diaskintest" is not used if the child has some kind of acute infection (he coughs, has a runny nose, heat and other symptoms), as well as for 1 month after recovery. The solution is not used for any diseases with chronic course, if they have worsened (first you need to treat such an exacerbation, and then do a test). A contraindication for such a drug is an allergic condition, in which allergy symptoms are first eliminated and only then Diaskintest is administered.

An obstacle to performing the test will also be any skin disease, in which there are pustules, rashes and other skin lesions in the forearm area. If a child visits an institution where quarantine has been declared for chickenpox or another infection, Diaskintest is used only after the quarantine period has ended.

If there is a risk that the child has become infected with the flu or other acute respiratory infections, it is also safer to postpone the test so as not to get a false result. positive result.

How is the test performed?

A test with a solution is prescribed by a doctor, and the injection must be given by a qualified nurse who has the right to conduct intradermal tests. "Diaskintest" should only be administered intradermally - injecting into a muscle or in any other way is unacceptable.

The solution is drawn up with a tuberculin syringe, which has a thin short needle with an oblique cut. Before doing the test, be sure to check the manufacturing date and expiration date. Two doses of the drug are taken into the syringe at once, after which the excess drug is released so that only 0.1 ml remains inside.

The child is in a sitting position during the injection. The injection is made in the forearm area - in the middle third. First, the skin in this place is treated with alcohol, then it is stretched and an injection is performed, the result of which should be a papule. Normally, such a papule is pale, looks like a “lemon peel”, and its diameter is 7–10 millimeters.

After the injection, the health worker must record in the documents exactly what drug was administered (its series, manufacturer, expiration date), when and where it was injected. Later, information about the sample result is added to this record.

If your child is prone to allergies or has any allergic diseases, Diaskintest should be administered in parallel with the use of antihistamines. It is recommended to start giving such medications five days before the injection. After giving the injection, they are used for another 2 days after the test.

No other preparation is needed for the administration of Diaskintest.

How often can I take the test?

If you use Diaskintest to replace the Mantoux test, then the frequency will be the same, that is, once a year. If the child does not have BCG, more frequent examinations are recommended - every six months. The test should be done twice a year and when chronic diseases, for example, for lung diseases, stomach ulcers or diabetes.

If the result is negative, then Diaskintest can be re-administered after two months. If the test was positive, then it can be repeated after any period of time when necessary.

Is it possible to wash and wet your hand?

It is allowed to wet the injection site after the test. If a child has been injected with Diaskintest, he can bathe, but it is better not to apply any detergents, and also do not rub the injection site with a washcloth.

• stick a patch on the sample site;
• wrap your hand with a bandage;
• treat the injection mark with brilliant green or other medicine;
• lubricate the injection site with any cosmetic product;
• scratch and rub your hand;
• go to the bathhouse or sauna;
• sunbathe in direct sunlight;
• visit a pool or swim in a natural body of water;
• engage in active sports;
• stay in frosty air for a long time.

Such restrictions are due to the fact that due to high or low temperature, contact with dirty water, cosmetics or sweat, the injection site of the allergen can become infected and inflamed, which will lead to an incorrect result.

When and how are the results checked?

The test with Diaskintest should be assessed 72 hours after the injection. It is checked by either a nurse or a doctor, measuring the transverse size of the infiltrate. A transparent ruler is used for measurement, and the result is recorded in millimeters.

If there are no papules (infiltrate), but there is an area of ​​redness, then measure the size of the hyperemia. If the infiltrate is present, but the skin around it is red, then the hyperemia is not taken into account, but only the papule is measured.

What is the result?

The test with Diaskintest is determined as follows:

• negative– if there is no redness, and the papule is completely absent;
• positive– when there is an infiltrate of any size;
• dubious– if the papules are not visible, but hyperemia is present.

If only an injection mark is visible on the child’s hand, the size of which does not exceed 2 mm, such a test is also considered negative.

What does a negative reaction mean?

This result occurs if:

• the child is not infected with mycobacteria;
• the child was previously infected, but the infection is inactive;
• The child was successfully treated for tuberculosis.

A negative reaction after a positive Mantoux test is likely confirmation that the child reacted to Mantoux with an allergy or a false positive result of such a test was due to a recent BCG vaccination.

However, the absence of a papule is not always a favorable sign. Any changes in the skin of the forearm after Diaskintest can also occur in cases of serious disorders of immune function, when the infection is severe.

In addition, a negative reaction is possible at the very beginning if the child has just become infected with mycobacteria, but his immune system has not yet responded.

Actions in case of a positive reaction

A positive result for Diaskintest indicates that the child’s body has already become “acquainted” with mycobacteria. Depending on the size of the infiltrate, a positive reaction is divided into:

• weakly expressed– if the papule is no more than 0.5 cm;
• moderately expressed– if the diameter of the infiltrate is from 5 to 9 mm;
• expressed– if the size of the papule is from 10 to 14 mm.

In the case when the infiltrate is very large (its diameter is more than 15 mm), they speak of a hyperergic reaction. This is also the name for the presence of necrotic changes or rashes in the area where the solution was administered. If your child has swollen lymph nodes or lymphatic vessels, these are also signs of a hyperergic reaction, even if the size of the papule is small.

If the reaction is assessed as positive, the child is sent for further examination in order to clarify the diagnosis of tuberculosis, because the test cannot accurately distinguish an active infectious process from a simple carriage.

To clarify the diagnosis, you need to take blood and urine tests, do fluorography or x-rays of the lungs, ultrasound and other examinations. The same measures are taken in the event of a questionable test result.

Side effects

Sometimes a nonspecific allergic reaction may occur to Diaskintest. It is often represented by redness at the injection site, which occurs almost immediately after the test. By the time the result is assessed (on day 3), as a rule, such hyperemia has passed and does not interfere with decoding. Other symptoms of an allergy to the solution are: itching, redness of the conjunctiva, urticaria, swelling of the nasal mucosa, and so on. In case of such complications, the patient should be given an antihistamine.

In some children, after the injection, their body temperature rises for a while, and headache, health worsens. Such general reaction It is rare and usually goes away on its own within a few hours (less often, within a few days). Local negative reactions to Diaskintest include swelling, bruising or abscess.

If the injection site is swollen and begins to fester, you should immediately show your baby to the doctor, as this indicates that bacteria have entered the wound.

Drug interactions

"Diaskintest" does not affect treatment with drugs that are taken orally. However, there are some restrictions for carrying out such a test and preventive vaccination. If the child is scheduled to be vaccinated, then Diaskintest should be administered before it. At negative reaction vaccination can be performed immediately after the test.

If the baby has received some kind of preventive vaccination, the test is allowed no earlier than a month after vaccination.

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.

Speaking scientific language, This recombinant allergen- microorganism protein, disease-causing. 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 reliable and effective technique detection of 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.

Main active substance, 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.

Persons belonging to the group high risk, this type of research should be preferred. 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.

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How is DST carried out?

With Diaskintest, the drug is administered subcutaneously with a special tuberculin syringe and a needle with an oblique cut. Use only a solution with no expired suitability. The sample requires 0.2 ml of the drug.

Photo 1. The injection is injected into top part 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 should appear in the form lemon peel size 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

Evaluates the result of a CI test medical worker, check is in progress 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. At positive reaction visually noticeable redness and swelling with a diameter 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.

The detection of Mycobacterium tuberculosis in the body for a long time occurred using the Mantoux test. At the same time, experts have always sharpened their attention to the fact that this diagnostic method is not always of sufficient quality. That is why in Lately Diaskintest began to gain popularity. It is an immunological test that can more accurately assess the results of human infection with pathogens such as Koch's bacillus. Today it is preferred by most specialists.

Drug for detecting tuberculosis

Carrying out Diaskintest involves injecting a special drug under the human skin. It contains two active components - antigens CFP10 and CFP16. They are present in virulent strains of Mycobacterium tuberculosis, but they are not present in typical vaccinations against of this disease– in BCG and BCG-m.

When determining whether to do Diaskintest or not, doctors still recommend the first option. This is because this method diagnosing the disease is more effective than the Mantoux test. It is completely safe and does not cause complications. Many parents prefer Diaskintest precisely because of these important factors.

Physiatry recognizes Diaskintest as one of the most advanced ways to examine a patient for tuberculosis. This is due to the following important aspects to pay attention to:

• the test is not a vaccination, but an allergy test;
• the accuracy of the result reaches 90 percent, while the Mantoux test gives the correct reaction only in 50-70 percent of cases;
• the drug does not contain mycobacteria, so infection is completely impossible.

Currently, some experts believe that the test for tuberculosis in the form of Diaskintest in the future will become the main method for diagnosing this disease.

Indications for the procedure

Tuberculin Diaskintest is prescribed to patients in several cases, among which phthisiatricians primarily distinguish the following:

1. Diagnosis of tuberculosis infection and assessment of its activity in the body at a specific moment. First of all, this applies to those cases where the doctor has a serious suspicion of the presence of the corresponding disease.
2. Carrying out differential diagnosis tuberculosis with other diseases that have similar symptoms.
3. Implementation of differential diagnosis of post-vaccination and infectious allergies. First of all, this applies to those cases when a person is in a group where there is any disease transmitted by airborne droplets or contact.
4. Observations on the effectiveness of tuberculosis therapy in combination with other methods of treating this disease.

Diaskintest is often performed in cases where calcification is detected on a fluorogram. Such a change may be evidence of the presence of Koch's bacillus in the lungs. In such a case, the doctor must clearly determine whether the bacterium is in the active stage or whether it is encapsulated. In the second case, there may not be any obvious symptoms of the problem.

Diaskintest allows you to determine whether a person is infected with Koch's bacilli, while approximately establishing the degree of activity of the disease development process. After receiving the results, the doctor evaluates them. If the tuberculin diagnosis is positive, the patient is referred for additional examination. And only after it has been carried out will a diagnosis be made and a specific treatment prescribed.

Contraindications for reactions with allergens

The presence of contraindications is not due to the fact that the drug can adversely affect the human body, but because in this case there is an increased risk of obtaining a false positive result.

There can be no complications after Diaskintest, especially since human infection is completely excluded!

Why and how the test is carried out

Long time The main method for diagnosing tuberculosis was the Mantoux test. It is used everywhere to this day. In addition, patients undergo an X-ray examination, which may show not infection with Koch’s bacillus, but the presence of certain changes in the lungs. Even PCR analysis of sputum does not always give a positive reaction if infection has occurred.

This is due to the fact that not at all stages of tuberculosis mycobacteria are released by airborne droplets. This all indicates that there is no truly 100% way to determine the disease. That is why, after a large-scale infection, they invented modern remedy Diaskintest. It is used because it gives a more correct result, in which many specialists have a high level of confidence. This has been proven by relevant studies conducted in special conditions laboratories. A 90% probability of confirming the diagnosis is a fairly accurate result.

Diaskintest is a fairly simple procedure, but all patients need to clearly know how it is done. In this case, they can evaluate the performance of health workers and monitor whether they comply with current instructions.

Test technique

Diaskintest after Mantoux is allowed. This is due to the fact that allergy tests cannot give a positive result due to vaccination. There should be no interval between these two procedures so that their results are as correct as possible. That is why, before injecting Diaskintest, the doctor does not need to know exactly about the recent Mantoux test. But at the same time, it’s worth talking about other vaccinations. Based on the collected data, a decision is made on the advisability of injecting the drug under the skin on the arm.

The technique for administering the Diaskintest injection is the same as when performing the Mantoux test. The person should be in a sitting position with his arms down. The doctor or nurse treats alcohol solution ethyl alcohol manipulation area, after which the skin is stretched for better needle insertion. After this part of the work is completed, Diaskintest is done by injecting 0.1 milliliter of the drug.

Immediately after the allergy test enters the body, a papule that looks like a lemon peel forms under the skin. It is distinguished by a whitish color and a fairly significant diameter - from 5 to 10 millimeters. In the future, the formation can either increase, which indicates the presence of problems, or decrease due to the fact that there are no Mycobacterium tuberculosis in the body.

The use of several methods for diagnosing tuberculosis on one arm is possible, but not advisable. That is why, if the Mantoux test is done on right hand, then doctors recommend performing Diaskintest on the left forearm.

How often is Diaskintest done?

An equally popular question is how often Diaskintest can be done. To determine this, you must follow the following instructions:

1. If a negative result was obtained, the next time the manipulation should be carried out after 60 days (2 months).
2. If any vaccination has been carried out (except Mantoux), the test is done after 30 days (1 month).
3. If the patient had an infectious disease, the procedure can be performed after 30 days (1 month).

In cases where the patient has had tuberculosis, Diaskintest is performed with a certain frequency. It is 1 time every 3-6 months. Such diagnostics allow us to understand how therapy actually works on the patient.

Koch's bacillus is often detected by Diaskintest even in cases where the Mantoux test was negative. Due to the fact that tuberculosis can be too dangerous for a person, doctors recommend combining these two examinations in order to ultimately obtain the most correct data on the state of health.

Evaluation of sample results

When conducting the Diaskintest, it is also important to understand how to evaluate its results in adults. This can be done either by the patient’s attending physician or by a specially trained nurse with relevant work experience.

72 hours after Diaskintest was done, several parameters of the injection site are usually checked. At this stage, the diameter of the papule and the size of the hyperemia are determined skin and the presence of infiltration.

Measurements are often carried out using a regular ruler. The specialist needs to record the length of the transverse (relative to the axis of the forearm) size of the formation in millimeters. This is how the data is compared with what the reaction to Diaskintest should be.

The result can be positive, negative or questionable (false positive). That is why you should clearly understand what the difference is between all these conditions after diagnostic procedure:

1. Negative result. In such a situation, the papule should not be more than 2 millimeters in diameter. In this case, infiltration and redness of the skin are completely absent. The presence of the mark can only be explained by the procedure of injecting a person into the right arm.
2. Doubtful (false positive result) on Diaskintest. The presence of redness or papules in this case is mandatory. But at the same time, infiltration is completely absent. The formation does not appear to be large in size - it is small or medium.
3. Positive result. In this situation, during the first days of the week, the reaction to Diaskintest will appear quite pronounced. This applies to the formation of a large or medium-sized papule, redness around it, as well as infiltration inside.

Positive test result

It is very important to understand what a positive Diaskintest looks like, since in this case you should immediately begin full examination and therapy for tuberculosis infection. If you do not take all necessary actions, there is a risk of developing the disease and causing adverse consequences that threaten human life and health.

A positive Diaskintest means that a person has Mycobacterium tuberculosis in the body. Analysis of the diagnostic result allows us to partially estimate how much. Conventionally, experts identify four possible options:

1. Mild reaction. In this situation, the dioskin test will not show the norm, but it will be difficult to notice significant changes at first glance. This is due to the fact that the papule will not be larger than 5 millimeters.
2. Moderate reaction. If they did it, and it shows such a result, we can assume that the disease is moving into the active stage of its development. The papule in this case will be within 5-9 millimeters.
3. Pronounced reaction. This result indicates that the person has been infected for some time, as a result of which the number of mycobacteria in his body is very significant. Severe infiltration is diagnosed when the papule reaches 10-14 millimeters.
4. Hyperergic reaction. In this case, the infiltrate is more than 15 millimeters. In this case, vesiculo-necrotic changes are present in the injection area. As a result, lymphadenopathy of nearby areas additionally develops. lymph nodes. They increase several times in size as blood passes through them.

As a result, only a doctor or nurse can evaluate what the patient’s result on Diakintest should be. Under no circumstances should you do this on your own, as you can easily make mistakes without the appropriate education and experience.

Diaskintest what you can not do after the test

Tuberculosis allergens are relatively safe substances that can be administered to a person to assess whether they have the disease. However, there are some restrictions after the drug enters the body:

• You should not apply any cosmetics, detergents or perfumes to the place where the sample was placed. They can provoke some kind of allergic reaction, thereby blurring the final result.
• It is not recommended to apply the test to the injection site medications in the form of creams, ointments and gels.
• Do not scratch or rub the injection site, as this can cause an infection.
• You should also not wrap your hand in a bandage or cover it with plasters.

Patients often have questions about what they should not eat if Diaskintest has been administered. In fact, there are no restrictions in this regard. A person can continue to eat all the same foods as before. The restrictions apply only to allergy sufferers - they should be careful about eating food so as not to provoke their own illness.

If the vaccination was after vaccination, then there is a risk that the papule on Diaskintest will be large. That is why these two procedures are often not done one after the other. To obtain more reliable examination results, it is necessary that at least 30 days pass between them. In this case, there will be no possibility of the appearance of a significant papule.

To summarize, it is worth noting that Diaskintest is the most accurate diagnostic method, giving a 90% probability of the result obtained. It is considered more effective than the mantoux sample and has no adverse reactions. Diaskintest is absolutely safe and in no case causes infection with Koch's bacillus.

When performing a Diaskintest, the results are assessed in a matter of days, which is an important factor during the diagnosis of tuberculosis, especially if the test is necessary for a child or people with low immunity.

Tuberculosis is a disease that spreads rapidly in crowded conditions. In addition, you can become infected with Koch's bacillus at the slightest, unintentional contact with a carrier of the disease.

What is the result of Diaskintest? Diaskintest - diagnostic event, which successfully replaces the Mantoux test during analysis for the presence of tuberculosis infection. Because of low level errors, tuberculosis testing is increasingly used to determine Koch's bacillus by identifying the patient's immune response.

Contrary to popular belief, testing is not a vaccination or vaccination, which makes the procedure as safe as possible for both children and adults.

• 90% of the world's population are carriers of the causative agent of the disease - Koch's bacillus;
• 1% of the infected population is at risk of developing the disease due to a decrease in immune defense;
• Tuberculosis is a disease, the first stages of which pass without the manifestation of specific symptoms.

Treatment of tuberculosis is a long and exhausting process; in addition, an infected person, unwillingly, poses a great threat to the life and health of family members. The longer the disease develops without proper assistance, the higher the likelihood of infecting relatives. Children under fourteen years of age, people with weak immune systems and pregnant women are at greater risk from the disease.

How to do Diaskintest

The Mantoux test and Diaskintest have a similar diagnostic principle:

1. The procedure is performed subcutaneously.
2. A solution with allergens (proteins to detect the body’s reaction; if the substance is familiar to the immune system, then tuberculosis agents are already present in the body) is injected into the forearm area.
3. Diaskintest results are assessed on the third day using a transparent measuring ruler.

Testing is carried out on the territory of private and municipal medical institutions, as well as in schools and preschool educational institutions.

In order for a person to be prescribed a diaskintest for tuberculosis, there are certain reasons:

The tuberculin test Diaskintest is considered one of the most modern analogues test for tuberculosis, in addition, the reliability of its result is much higher than that of the Mantoux test.

According to modern legislation of the Russian Federation, a person can refuse vaccinations, vaccinations or postpone them for one reason or another. The same applies to refusal to hold an event that a parent can arrange for their child.

It is also worth noting that in order to carry out the Mantoux test, diaskintest or other procedures on a child, written permission from the parent or official guardian is required. Refusal to vaccinate means that a person accepts everything possible consequences solutions.

To write permission or refuse vaccination, you must fill out forms and certificates received from the teacher; the application can also be completed in free form.

For each medical event carried out in educational institution, a separate form is required (it is advisable to fill out two copies so that one of them remains with the parent). It is prohibited to carry out diagnostics without consent to conduct a diaskintest.

Before choosing the Diaskintest test for tuberculosis or refusing to perform it, you need to weigh the consequences and evaluate the contraindications to the test. If a child or an adult has serious reasons associated with contraindications, after consultation with a TB doctor, you can select an analysis option with fewer side effects for a particular disease.

How is the Diaskintest result checked?

Preparation for the analysis includes identifying contraindications. If they have been identified, it is recommended to replace Diaskintest with an analogue.

1. Negative reaction.
2. False positive or doubtful.
3. Positive.

Features of the test, such as the introduction of antigens different from those used during BCG, increase the reliability of testing and reduce the risk of a false-positive reaction. This is a significant advantage over its previous analogue - the Mantoux test.

A negative Diaskintest or “normal” means that there are no pathogenic agents of the disease in the patient’s body and the immune system is unfamiliar with tuberculosis.

• visible injection mark;
• a small bruise up to two millimeters in diameter;
• a compaction under the skin not exceeding one centimeter.

After testing, slight redness should be present. A test without any reaction before and after the test, as in the case of the Mantoux test, is invalid.

False positive result

Signs of a false-positive diaskintest:

• redness of more than four millimeters;
• upon manifestation allergic reaction on the composition of the drug.

After the manifestation of such symptoms, a repeat test is prescribed after a period of two months; it is also possible to prescribe other diagnostic methods.

In addition to the analysis for the presence, after the diaskintest, the evaluation of the results determines the amount of Koch's bacillus.

1. Swelling up to five millimeters in diameter is a slight amount.
2. Swelling of five to nine millimeters is a moderate or moderate amount.
3. More than ten millimeters is a pronounced amount.

The stronger the inflammation around the injection site, the more tuberculosis agents are in the body.

How are the child’s results assessed? The size of a positive reaction in a child should be assessed by a doctor, since the manifestation in children of different ages are different.

If a positive reaction to tuberculosis occurs, it is necessary to conduct a full examination as quickly as possible and analyze the location of the disease in order to prescribe precise treatment for the disease.

Advantages and comparison with other tests

Diaskintest is a relatively new and rapidly spreading test that has gained the trust of patients thanks to its formula and the objectivity of the result.

• testing using this method makes it possible to identify patients with tuberculosis with greater accuracy;
• refutes the false positive reaction of the Mantoux test when undergoing BCG vaccination;
• is characterized by high sensitivity to tuberculosis agents, which makes it possible to detect not only active, but also Koch’s bacillus that has just begun to develop in the body;
• allows you to accurately determine the absence of the pathogen in people who have completed the full course of anti-tuberculosis therapy.

Like analogs, Diaskintest does not provide information about the stage and localization of tuberculosis, therefore, after a positive or questionable reaction occurs, the patient should immediately consult a TB doctor for a more accurate examination and identification of foci of inflammation.

Like other drugs, Diaskintest has contraindications, in the presence of which it is necessary to refuse the procedure or find a suitable diagnostic analogue.

1. The presence of bacterial or viral diseases in an active form.
2. If the patient has severe skin disorders, dermatitis.
3. Diagnosed epilepsy.
4. During an exacerbation of an allergic reaction or in the presence of an allergy to the components of the drug.
5. Carrying out any vaccination less than a month before diagnosis.
6. During exacerbations of diseases internal systems body.

Contraindications have a negative impact on the human body and reduce the reliability of the diagnosis.

These side effects are included in the list of natural manifestations after diaskintest. However, if their manifestation is too strong or additional side effects are observed, you should consult a doctor.

Diagnostics does not pose a risk of contracting tuberculosis, since the drug does not contain active mycobacteria of the disease.

Laboratory diagnosis of tuberculosis

In addition to the Mantoux test and Diaskintest, more accurate methods used in laboratory conditions are used to analyze tuberculosis.

1. General blood analysis.

PCR is considered to be the most accurate among all those listed because of the diagnostic method and the ability to diagnose all body fluids, identifying not only the development of the disease, but also a predisposition to the development of the disease. This is how chlamydia and other bacterial diseases are diagnosed.

Thus, sexually transmitted tuberculosis during a severe decrease in immune defense (infection occurs as a secondary infection during pulmonary tuberculosis or transmitted by contact), develops due to high level phosphates in urine.

Features of phosphates in urine during pregnancy

Pregnant women are at particular risk from tuberculosis, so compliance with all prescribed procedures and studies is vital for both the woman and the life of the unborn baby.

• the urine becomes cloudy and sediment forms in it;
• renal colic;
• pain and difficulty urinating.

Disruption of internal processes in the body often leads to the development of various pathologies.

If there is increased protein in the urine of a child, then the reasons for this are due to the following diseases:

Protein excreted along with urine symbolizes the development of diseases, including tuberculosis.

However, during the collection of material for analysis in children early age problems may arise.

• using a special urinal;
• clean plastic oilcloth or bag;
• glass or plastic jar.

For boys, the method of collecting urine is similar.

After the diagnosis, the norm and other types of reactions are revealed that need to be carried out to study the child’s condition.

It was noticed that when taking ELISA tests and PCR result tests may vary.

Laboratory tests have their pros and cons and often complement each other’s shortcomings, so TB doctors prescribe a comprehensive study using several techniques.

In addition, people work in laboratories, which means there is always the possibility of introducing a “human factor”, so you should not calm down or be upset after receiving one analysis. For a complete diagnosis, it is recommended to undergo all prescribed procedures.

Tuberculosis is a disease that is transmitted not only from one person to another, but can also affect domestic animals, including cattle. To preserve the health of pets (as well as to avoid infection with infections dangerous to humans), animals, just like people, are usually vaccinated. In addition to BCG, other drugs are also used for animals (vacderm vaccine). Some of the activities must be carried out in veterinary clinics, others can be carried out independently, having studied the application and dosage medicine.

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• Congratulations! The likelihood that you will develop tuberculosis is close to zero.

  But don’t forget to also take care of your body and undergo regular medical examinations and you won’t be afraid of any disease!
  We also recommend that you read the article on.

• There is reason to think.

  It is impossible to say with certainty that you have tuberculosis, but there is such a possibility; if this is not the case, then there is clearly something wrong with your health. We recommend that you immediately go through medical examination. We also recommend that you read the article on.

• Contact a specialist urgently!

  The likelihood that you are affected is very high, but it is not possible to make a diagnosis remotely. You should immediately contact a qualified specialist and undergo a medical examination! We also strongly recommend that you read the article on.

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Task 1 of 17

1 .

Is your lifestyle associated with severe physical activity?

1. Task 2 of 17

   2 .

   How often do you take a tuberculosis test (eg Mantoux)?

2. Task 3 of 17

   3 .

   Do you carefully observe personal hygiene (shower, hands before eating and after walking, etc.)?

3. Task 4 of 17

   4 .

   Do you take care of your immunity?

4. Task 5 of 17

   5 .

   Have any of your relatives or family members had tuberculosis?

5. Task 6 of 17

   6 .

   Do you live or work in an unfavorable environment(gas, smoke, chemical emissions from enterprises)?

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   How often are you in damp, dusty or moldy environments?

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   8 .

   How old are you?

8. Task 9 of 17

Until 2009 in Russia, the diagnostic tests for detecting tuberculosis were fluorography and tuberculin diagnostics (Mantoux test). Currently, in addition to them, more modern methods are also used, one of which is the Diaskintest for tuberculosis.

Active substance: synthesized proteins of tuberculosis bacteria CFP10 ESAT6.

Auxiliary:

• phenol;
• sodium and potassium phosphates;
• polysorbate 80;
• sodium chloride;
• distilled water.

Purpose and instructions for use

The Diaskintest test is prescribed to adults and children after one year to determine:

• presence of tuberculosis infection;
• stage of the disease, if present;
• the presence of an allergy to the vaccine;
• control the treatment process.

Contraindications

Contraindications to Diaskintest are as follows:

• infectious diseases V acute form if there is no suspicion of tuberculosis;
• other acute diseases;
• the presence of skin diseases;
• allergic reactions;
• colds, acute respiratory pathology;
• runny nose (rhinitis) and cough (tonsillitis), since these are infectious diseases, and therefore the test cannot be performed on either a child or an adult.

Important! If at school or kindergarten quarantine, the test is done only after it is cancelled.

Administration technique and dosage

The instructions for use oblige the Diaskintest test to be taken only after a doctor’s prescription. It is carried out by a medical professional with permission to conduct such tests.

1. The injection site is the middle third of the forearm.
2. The test is placed on the less active hand (for a right-handed person - on the left, for a left-handed person - on the right). Options are possible when Mantoux is placed on the left forearm and Diaskintest on the right.
3. The injection site is wiped with seventy percent ethyl alcohol.
4. A special tuberculin syringe with a thin needle is injected intradermally.
5. The dose is 0.1 milliliter.

Diaskintest technique

The need for

Parents are concerned about the safety and necessity of Diaskintest for their children. On this issue, the following can be said in his defense:

Ninety-five percent of the adult population carry Koch's bacillus, that is, they have a latent tuberculosis form and can infect a child. This form is hidden, but under unfavorable conditions it can become active. Therefore, a previously identified pathogen, with the help of diagnostics, will not allow the disease to manifest itself, and identifying a hidden infectious process will increase the chance of recovery.

Diagnostic places

The Diaskintest test is carried out by the following institutions:

• schools;
• kindergartens;
• clinics;
• anti-tuberculosis dispensaries and institutes.

Frequency

Ministry of Health Russian Federation It is recommended that children of school age be tested annually.

The norms for conducting Diaskentest are guided by the following rules:

• The test can be repeated only after two months.
• After the postponed acute infection- one month.
• Any vaccination - one month.
• If the test result is positive, follow-up tests are carried out every three to six months.

In children, it is possible to perform a test after one year, if Mantoux was positive.

Results and their evaluation

Evaluation of Diaskintest results in children and adults takes place after three days. This is done exclusively by a specialist. He looks at the body's reaction at the injection site. The indicators of the disease depend on how this trace looks. They are distributed according to three criteria:

1. in the absence of redness, and if the spot is no more than two millimeters - negative (the norm in children and adults);
2. with severe redness, but there is no infiltrate - doubtful (false positive);
3. a visible compaction (infiltrate) is formed - positive.

Diaskintest results begin on the first day. Over the next three days, the process increases, giving maximum effect. Then it begins to decline, at which time it is no longer possible to evaluate it correctly.

Negative

The diaskintest norm is a negative result. Possible manifestations:

• the presence of a small injection mark;
• the presence of a millimeter bruise;
• centimeter seal, in the form of a “button” or “lemon peel”.

That is, with a normal negative result, there should be no redness or papule.

Doubtful

A questionable manifestation is the presence of redness at the site of the test, but the absence of a papule.

If Diaskintest gives a false positive result, the patient is sent to an anti-tuberculosis institution. There he passes additional diagnostics, takes tests, undergoes an x-ray examination. According to the rules, after two months the Diaskintest can be done again.

Positive

Diaskintest positive result - the presence of an inflamed papule. This indicates the presence of tuberculous mycobacteria.

Adults

With a positive test in adults, the size of the infiltrate depends on the amount of pathogen in the body:

• no more than five millimeters - small;
• no more than nine - moderate;
• from ten to fifteen - pronounced;
• more than fifteen - hyperergic.

It is necessary to register with a tuberculosis dispensary and undergo adequate treatment.

Children

For children. Those whose Diaskintest gave a positive result must undergo additional diagnostics to determine the activity of the disease. But even if the disease is in a latent form, treatment is still carried out for three months with anti-tuberculosis drugs (isoniazid).

False result

Sometimes, Diaskintest can give a questionable or positive result in the absence of infection. This happens in the following cases:

• If no diseases have been detected for which the test is contraindicated. For example: availability viral infection unexpressed nature, autoimmune diseases.
• An unexpected reaction to any allergen, so the test is carried out in allergy sufferers only together with antihistamines prescribed by a doctor.
• Infection at the injection site, especially in children.

Additional side effects

The Diaskintest tuberculosis test is sometimes accompanied by rare manifestations:

• increased temperature;
• weakness;
• headache.

However, there is no need to worry. Normal reaction occurs immune system for the drug.

Before and after the test

To ensure that the Diaskintest test does not give a false result, you must adhere to some rules:

• you cannot do it if there are contraindications;
• adults should abstain from alcohol;
• do not smear the injection site with various products;
• do not scratch;
• Do not cover the injection site with a bandage or plaster.

According to Dr. Komarovsky, the injection site can be wetted, but you should refrain from bathing the child.

Advantages and comparison with other tests

The advantage of the test over such diagnostic methods, such as x-ray, fluorography, CT scan, in that during its implementation the human body is not exposed to radiation.

Mantoux test and Diaskintest differences:

• Diaskintest contains only synthetic antigens, so the possibility of contracting tuberculosis is zero;
• it can be used by a child from one year of age;
• reacts only to active mycobacteria, and only those causing tuberculosis;
• according to the degree of accuracy of the results (the accuracy of Mantoux is fifty to seventy percent, and Diaskintest is ninety).

But at the same time, it is impossible to say unequivocally which is better: Diaskintest or Mantu. They are not interchangeable. The test is often prescribed to a child if the Mantoux test is positive, since it can give a false reaction to other mycobacteria that do not cause tuberculosis, or to BCG vaccination. But it may not show infection with the bovine strain of tuberculosis. Therefore, first they still carry out the Mantoux test, and in case of doubt, Diaskintest.