Tuberculin skin test and serum albumin among sputum smear positive pulmonary tuberculosis patients in Maiduguri, Nigeria

Abstract

Background: Delayed-type hypersensitivity reaction, the hallmark of the Mantoux response is markedly depressed in the setting of malnutrition. Objectives: To determine the relationship between the intensity of Mantoux responses and serum albumin in patients with sputum smearpositive non-HIV associated pulmonary tuberculosis. Methods: This was an observational crosssectional study of consecutive newly diagnosed sputum smear positive Pulmonary Tuberculosis (PTB) patients that were HIV-negative. Five tuberculin units of Purified Protein Derivative (PPD) was injected intradermally and response determined after 72 hours. Serum albumin was measured using Colorimetric Bromocresol green method. Results: Seventy three patients, 44 (60.3%) males and 29 (39.7%) females with a mean age of 31.2 ± 11.8 years were enrolled. The mean Mantoux response and serum albumin were 12.5 ± 7.3 mm and 3.5 ± 0.5 g/dl, respectively. Thirty three (45.3%) patients had serum albumin level < 3.5 g/dl and forty (54.8%) patients had serum albumin level of ≥ 3.5 g/dl. Eight (10.96%) patients with serum albumin < 3.5 g/dl had Mantoux response of 0 mm, whereas 1 (1.37%) had Mantoux of 8 mm. Twenty four with serum albumin of <3.5g/dl had Mantoux of ≥ 10 mm. Of those with serum albumin ≥ 3.5 g/dl, 7 (9.59%) had Mantoux response of 0 mm and 33 (45.21%) had response of ≥10 mm. There were no significant difference between Mantoux responses of 0 mm and ≥ 10 mm between patients with serum albumin of < 3.5 g/dl (p = 0.68) and those of ≥ 3.5 g/dl (p = 0.33). Conclusion: The study has shown that the magnitude of Mantoux response is independent of the levels of serum albumin among patients studied.