Applied Medical Research www.scopemed.org DOI: 10.5455/amr.20150131071624 26 AMR ● 2015 ● Vol ● Issue 1 INTRODUCTION Mantoux test is an intradermal skin test used to demonstrate delayed type of hypersensitivity (DTH) reaction against Mycobacterium tuberculosis (TB). TB has been an infectious disease continuingly being identified as responsible for severe morbidity and mortality thorough out the world. The intensity of this disease is more severe in the poor, developing and third world nations owing to various social and demographic factors that include overcrowding, poor hygiene, lack of proper nutrition etc.,. Although the laboratory diagnosis of TB by conventional methods are available in most of the centers that include Ziehl–Neelsen’s staining method and culture on Lowenstein– Jensen’s medium, the factors that limit accuracy of diagnosis include availability of an efficient microscopist and that the traditional culture takes a long time before confirmation. Availability of advanced techniques like fluorescent staining, culture (Mycobacterium growth indicator tube) and nucleic acid detection by polymerase chain reaction have revolutionized the laboratory diagnosis of TB. In the era of emergence of multi-drug resistant TB, laboratory diagnosis of TB, initiation of appropriate anti-tubercular therapy and regular follow-up of infected patients assumes greater significance. Owing to the fact that most of the laboratory methods require sophisticated instruments, skilled manpower and good infrastructure, many poor and financially weak nations cannot afford to utilize them. Among the available laboratory techniques, acid-fast staining and mantoux test are cost-effective and can be easily performed by trained medical personnel [1-3]. The present review focuses on the utility of mantoux test in the laboratory diagnosis of TB. HISTORICAL ASPECTS The bacterium Mycobacterium TB was first described by Robert Koch in 1882 [4]. Initially, the mantoux test was applied by German physician Felix Mendel in 1908 and later was modified and used by Charles Mantoux in the year 1912. This test is also in use till date on the name of scientist Charles Mantoux. Though mantoux test is used for the demonstration of DTH against Mycobacterium TB, its significance as a laboratory diagnostic method for the diagnosis of TB is still in debate. This is mainly due to the introduction of the vaccine Bacillus Calmette Guerin (BCG) and that in the developing countries and the endemic parts of the world most of the individuals are exposed to tubercle bacilli or have been infected sub clinically. Owing to the causes discussed earlier and many other factors, Revisiting Mantoux test in the era of immunization and Multi-drug resistant tuberculosis Venkataramana Kandi Review Article Department of Microbiology, Prathima Institute of Medical Sciences, Karimnagar, Andhra Pradesh, India Address for correspondence: Address for correspondence: Venkataramana Kandi, PhD, FAGE, Department of Microbiology, Prathima Institute of Medical Sciences, Karimnagar, Andhra Pradesh, India Microbiology. Phone: +91-9440704234, E-mail: ramana_20021@rediffmail. com Received: Received: January 14, 2015 Accepted: Accepted: January 31, 2015 Published: Published: February 07, 2015 ABSTRACT This review reinvents the role of mantoux test/tuberculin skin test (TST) in the laboratory diagnosis of tuberculosis (TB). TB has been the most significant infectious disease responsible for severe morbidity and mortality worldwide. Asia and African continents constitute most of the burden of world TB. Although a treatable infectious disease, the exposed individuals do not always show clinical signs of infection. TB may be present latent in many infected population. Clinical, radiological, cultural and staining methods, molecular techniques and many other advanced laboratory methods are available for the diagnosis of TB. Among the various laboratory techniques available for the diagnosis of TB, Mantoux TST is a low cost and easily done test that if performed and interpreted appropriately can be used for diagnosis of TB. KEY WORDS: Mantoux test, laboratory diagnosis of tuberculosis, tuberculin skin test