Русский
Experience of using tubercular recombinant allergen in examination of school-age children living in rural areas
DOI: https://dx.doi.org/10.18565/pharmateca.2024.1.134-140
Mordyk A.V., Romanova M.A., Shapran A.A., Bagisheva N.V., Moiseeva M.V.
1) Omsk State Medical University, Omsk, Russia; 2) Omsk Central District Hospital, Omsk, Russia
Background. The use of a test with the tubercular recombinant allergen (TRA) expands the possibilities of detecting tuberculosis. This applies to both individual population groups (children, patients with comorbid somatic pathology, immunodeficiency) and individual areas of residence (rural areas), where laboratory and instrumental diagnostic capabilities are limited.
Objective. Evaluation of the role of immunodiagnostics and the results of the TRA test (tubercular recombinant allergen) in identifying tuberculosis infection in children living in rural areas.
Methods. The study included 13,285 children aged 8 to 17 years living in the Omsk district of the Omsk region. Median age Me (25%; 75%) 14 (8.0; 17.0) years. All children underwent an annual TRA test and the results were assessed after 72 hours.
Results. During 2023, TRA tests were administered to 100% of the assigned school-age child population. Of these, 56 children (0.4%) showed a positive reaction to TRA (Diaskintest), in 14 children the TRA test was questionable (hyperemia). Of the patients with a positive test, 49 (0.5%) were children from 8 to 14 years old and 7 (0.2%) were from 15 to 17 years old. The majority had a normergic reaction. Patients with a positive TRA test underwent additional examination. In 62.0% of such patients, no changes were detected according to chest MSCT. In 19 (38.0%) of the examined patients, the following changes were revealed by chest MSCT: dense foci in the lung tissue, calcifications in the bronchopulmonary and paratracheal lymph nodes (calcification sizes from 1.5 to 9.1 mm). Next, all 56 children with a positive reaction to Diaskintest were offered preventive chemotherapy, of which 50 patients (89.3%) received treatment, 6 children (10.7%) did not receive treatment (parental refusal). According to the results of a survey at the end of 2023, no cases of tuberculosis were identified among school-age children.
In conditions of limited diagnostic capabilities of rural healthcare, immunodiagnosis is a mandatory component of annual preventive examination of the child population for tuberculosis, with the subsequent formation of risk groups of individuals with a positive reaction to TRA for additional examination and courses of preventive chemotherapy.
Objective. Evaluation of the role of immunodiagnostics and the results of the TRA test (tubercular recombinant allergen) in identifying tuberculosis infection in children living in rural areas.
Methods. The study included 13,285 children aged 8 to 17 years living in the Omsk district of the Omsk region. Median age Me (25%; 75%) 14 (8.0; 17.0) years. All children underwent an annual TRA test and the results were assessed after 72 hours.
Results. During 2023, TRA tests were administered to 100% of the assigned school-age child population. Of these, 56 children (0.4%) showed a positive reaction to TRA (Diaskintest), in 14 children the TRA test was questionable (hyperemia). Of the patients with a positive test, 49 (0.5%) were children from 8 to 14 years old and 7 (0.2%) were from 15 to 17 years old. The majority had a normergic reaction. Patients with a positive TRA test underwent additional examination. In 62.0% of such patients, no changes were detected according to chest MSCT. In 19 (38.0%) of the examined patients, the following changes were revealed by chest MSCT: dense foci in the lung tissue, calcifications in the bronchopulmonary and paratracheal lymph nodes (calcification sizes from 1.5 to 9.1 mm). Next, all 56 children with a positive reaction to Diaskintest were offered preventive chemotherapy, of which 50 patients (89.3%) received treatment, 6 children (10.7%) did not receive treatment (parental refusal). According to the results of a survey at the end of 2023, no cases of tuberculosis were identified among school-age children.
In conditions of limited diagnostic capabilities of rural healthcare, immunodiagnosis is a mandatory component of annual preventive examination of the child population for tuberculosis, with the subsequent formation of risk groups of individuals with a positive reaction to TRA for additional examination and courses of preventive chemotherapy.
About the Autors
Corresponding author: Natalya V. Bagisheva, Cand. Sci. (Med.), Associate Professor at the Department of Outpatient Therapy and Internal Diseases, Omsk State Medical University; Omsk Central District Hospital, Omsk, Russia; ppi100@mail.ru
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