The Heaf test, a

diagnostic Diagnosis is the identification of the nature and cause of a certain phenomenon. Diagnosis is used in many different disciplines, with variations in the use of logic, analytics, and experience, to determine "cause and effect". In systems enginee ...

skin test, was long performed to determine whether or not children had been exposed to

tuberculosis Tuberculosis (TB) is an infectious disease usually caused by '' Mycobacterium tuberculosis'' (MTB) bacteria. Tuberculosis generally affects the lungs, but it can also affect other parts of the body. Most infections show no symptoms, ...

infection. The test was named after F. R. G. Heaf. Also known as the Sterneedle test, it was administered by a Heaf gun (trademarked "Sterneedle"), a spring-loaded instrument with six needles arranged in a circular formation which was inserted in the wrist or shoulder. The Heaf test was discontinued in 2005 because the manufacturer deemed its production to be financially unsustainable after manufacturers could not be found for

tuberculin Tuberculin, also known as purified protein derivative, is a combination of proteins that are used in the diagnosis of tuberculosis. This use is referred to as the tuberculin skin test and is recommended only for those at high risk. Reliable admi ...

or Heaf guns. Until 2005, the test was used in the United Kingdom to determine if the BCG vaccine was needed; the

Mantoux test The Mantoux test or Mendel–Mantoux test (also known as the Mantoux screening test, tuberculin sensitivity test, Pirquet test, or PPD test for purified protein derivative) is a tool for screening for tuberculosis (TB) and for tuberculosis diagn ...

is now used instead. The Heaf test was preferred in the UK, because it was thought to be easier to interpret, with less variability between observers, and less training was required to administer and read the test. Patients who exhibited a negative reaction to the

test Test(s), testing, or TEST may refer to: * Test (assessment), an educational assessment intended to measure the respondents' knowledge or other abilities Arts and entertainment * ''Test'' (2013 film), an American film * ''Test'' (2014 film), ...

were considered for BCG vaccination. The Heaf test was used to test for tuberculosis in

adolescents Adolescence () is a transitional stage of Developmental biology, physical and psychological Human development (biology), development that generally occurs during the period from puberty to adulthood (typically corresponding to the age of majo ...

aged around 13–14. __TOC__

Procedure

A Heaf gun was used to inject multiple samples of testing serum under the skin at once. The needle points were dipped in tuberculin purified protein derivative (PPD) and pricked into the skin. A Heaf gun with disposable single-use heads was recommended. The gun injected PPD equivalent to 100,000 units per ml to the skin over the flexor surface of the left forearm in a circular pattern of six. The test was read between two and seven days later. The injection could not be into sites containing superficial veins. The reading of the Heaf test was defined by a scale: * Negative - No induration, maybe six minute puncture scars * Grade 1 - four to six

papules A papule is a small, well-defined bump in the skin. It may have a rounded, pointed or flat top, and may have a dip. It can appear with a stalk, be thread-like or look warty. It can be soft or firm and its surface may be rough or smooth. Some h ...

(also considered negative) * Grade 2 - Confluent papules form indurated ring (positive) * Grade 3 - Central filling to form disc (positive) * Grade 4 - Disc >10 mm with or without blistering (strongly positive) Grades 1 and 2 could result from previous BCG or avian tuberculosis, rather than human TB infection. Children who were found to have a grade 3 or 4 reaction were referred for

X-ray An X-ray, or, much less commonly, X-radiation, is a penetrating form of high-energy electromagnetic radiation. Most X-rays have a wavelength ranging from 10 picometers to 10 nanometers, corresponding to frequencies in the range 30&nb ...

and follow-up. For interpretation of the test, see

Tuberculosis diagnosis Tuberculosis is diagnosed by finding ''Mycobacterium tuberculosis'' bacteria in a clinical specimen taken from the patient. While other investigations may strongly suggest tuberculosis as the diagnosis, they cannot confirm it. A complete medical ...

Other tests

The equivalent

positive levels done with 10 TU (0.1 mL 100 TU/mL, 1:1000) are * 0–4 mm induration (Heaf 0-1) * 5–14 mm induration (Heaf 2) * >15 mm induration (Heaf 3-4) The

is preferred in the

United States The United States of America (U.S.A. or USA), commonly known as the United States (U.S. or US) or America, is a country Continental United States, primarily located in North America. It consists of 50 U.S. state, states, a Washington, D.C., ...

for the diagnosis of tuberculosis; multiple puncture tests, such as the Heaf test and

Tine test The tine test is a multiple-puncture tuberculin skin test used to aid in the medical diagnosis of tuberculosis (TB). The tine test is similar to the Heaf test, although the Mantoux test is usually used instead. There are multiple forms of the tin ...

, are not recommended.

References

* Joint Tuberculosis Committee of the British Thoracic Society,
Control and prevention of tuberculosis in the United Kingdom: Code of Practice 2000
' BMJ 2000:55:887-901
Table 3 Heaf Test
grading, reaction, and equivalent Mantoux positive levels. {{Tuberculosis Immunologic tests Tuberculosis