Ability of caregivers to read delayed hypersensitivity skin tests in children exposed to and infected by HIV

Abstract

Objectives: To identify whether nonmedical home caregivers (parents, guardians) could accurately interpret the results of delayed hypersensitivity skin tests in children, thereby obviating the need for a return visit for a professional reading. Methods: Patients who were enrolled in the Pediatric Pulmonary and Cardiac Complications of HIV (P 2C 2HIV) study were given annual skin tests to tuberculin purified protein derivative, Candida, and tetanus as part of the study protocol. Caregivers were instructed verbally about how to read and measure erythema and induration. They were given written instructions to take home as well and were asked to return in 48 to 72 hours for the professional reading. On the morning of their return visit, they were to read the skin tests and record the results before coming to the clinic. Results: When compared with readings by professional staff, caregivers had a high percentage of false-negative readings for both Candida (24%) and tetanus (41%) skin tests. These false-negative readings did not correlate with age, gender, race, or educational level of the caregivers. Conclusions: The high percentage of false-negative readings by the caregivers emphasizes the need for professional reading of delayed hypersensitivity skin tests. J Pediatr Health Care. (2000). 14, 50–55.