Results on tuberculosis detection in children and adolescents in Karelian Republic and evaluation tests with preparation "Diaskintest" in risk groups for tuberculosis

Research results of using preparation "Diaskintest" (DST) in 551 children and adolescents observed in TB dispensary of Karelian Republic (RK) are presented. The obtained results also included data on 29 diseased children and children from contact group. These results confirm high sensitivity (in all patients with localized forms of tuberculosis DST was positive) and specificity of DST (in all children with postvaccinal allergies a negative reaction to the DST was observed). This allows to differentiate postvaccinal and postinfectious allergies in children. The use of DST in children with primary infections (VI A group) and hyper reaction to Mantoux test (VI B group) revealed an active TB infection, significantly reduced the amount of X-ray tomographic surveys, and decreased dynamic observations by phthisiatrician and unnecessary use of prophylactic treatment. High frequency of positive reactions to DST was observed in the group of contact (50,6 %). The incidence of TB in this group in RK amounted to 1324,8 per 100 thousand (IVA - 2020,2 per 100 thousand, in IVB - 332,6 per 100 thousand), exceeding by 37 - 123 times the incidence of TB among children population. In the majority of cases (13 of 26) contacts with the MBT infected were identified only retrospectively. After TB detection (1/2 of them had contact with patients who carried MBT strains of multidrug-resistant (MDR) it was revealed that two thirds had a family tuberculosis contact. Given the high incidence of the disease in children who had TB contacts and who live in socially disadvantaged families it is necessary to improve efforts helping to identify their contacts. It is also essential to increase the number of health resorts for children in order to separate them from tuberculosis infected contacts and isolate them from centers of tuberculosis outbreaks.