BackgroundA group of Russian scientists has developed Diaskintest, which comprises Mycobacterium tuberculosis-specific recombinant proteins CFP10-ESAT6, for skin testing (0.2 μg/0.1 ml).Study purposeTo evaluate the comparative sensitivity of TST with 2 TU PPD-L and a skin test with tuberculous recombinant allergen (Diaskintest) containing the ESAT6-CFP10 protein in children and adolescents with newly diagnosed active tuberculosis during mass screening in the primary medical service in Moscow.Materials and methodsThe trial was a comprehensive retrospective group study of children and adolescents diagnosed in Moscow with active tuberculosis in 2013–2016, aged 0 to 17 years inclusive.ResultsFrom 441 patients selected for analysis 408 patients had both tests (TST with 2 TU PPD-L and Diaskintest) performed, in 193 patients both tests were given simultaneously, of them 162 patients were BCG-vaccinated. Comparative results of both tests in 408 patients with tuberculosis: at cut-off ≥ 5 mm, both tests has similar sensitivity: Diaskintest 98.3% (95% CI 97.0–99.6%), TST 98.0% (95% CI 96.7–99.4%), at cut-off ≥10 mm, the sensitivity decreases for both tests: Diaskintest 90.0% (95% CI 87.0–93.0%), TST 88.7% (95% CI 85.6–91.9%), but at cut-off ≥ 15 mm, the decrease in sensitivity is statistically significant: for Diaskintest 61.5% (95% CI 56.7–66.3%), and for TST 46.3% (95% CI 41.4–51.3%), p <0.0001.The results of simultaneous setting of tests on different hands in 193 people (including 162 BCG-vaccinated), do not differ from the results for 408 people.The correlation between the results of Diaskintest and TST was significant in all groups.ConclusionIn children and adolescents with active tuberculosis, Diaskintest of 0.2 μg/ml and the Mantoux test with 2 TU PPD-L have high sensitivity (98%) at a cut-off of 5 mm; however, at cut-off ≥ 15 mm sensitivity is significantly reduced, and the decrease is more pronounced in the Mantoux test. The advantage of Diaskintest is that, unlike the Mantoux test, it has high specificity under the conditions of mass BCG vaccination. The test is simple to carry out, and can be used in mass screening.

Background. A group of Russian scientists has developed Diaskintest, which comprisesMycobacterium tuberculosis-specific recombinant proteins CFP10-ESAT6, for skin testing (0.2 µg/0.1 ml).Study purpose: to evaluate the comparative sensitivity of TST with 2 TU PPD-L and a skin test with tuberculous recombinant allergen (Diaskintest) containing the ESAT6-CFP10 protein in children and adolescents with newly diagnosed respiratory tuberculosis during mass screening in the primary medical service in Moscow, 2013Moscow, -2016 Materials and methods. The trial was a comprehensive retrospective group study of children and adolescents diagnosed in Moscow with respiratory tuberculosis in 2013-2016, aged 0 to 17 years inclusive. From 441 patients selected for analysis 408 patients had both tests (TST 2 with 2 TU PPD-L and Diaskintest) performed, in 193 patients both tests were given simultaneously, of them 162 patients were BCG-vaccinated. Results. Comparative results of both tests in 408 patients with tuberculosis: at cut-off ≥ 5 mm, both tests has similar sensitivity: Diaskintest 98.3 % (95 % CI 97.0-99.6 %), TST 98.0 % (95 % CI 96.7-99.4 %), at cut-off ≥ 10 mm, the sensitivity decreases for both tests: Diaskintest 90.0 % (95 % CI 87.0-93.0 %), TST 88.7 % (95 % CI 85.6-91.9 %), but at cut-off ≥ 15 mm, the decrease in sensitivity is statistically significant: for Diaskintest 61.5 % (95 % CI 56.7-66.3 %), and for TST 46.3 % (95 % CI 41.4-51.3 %), p <0.0001. The results of simultaneous setting of tests on different hands in 193 people (including 162 BCG-vaccinated), do not differ from the results for 408 people. The correlation between the results of Diaskintest and TST was significant in all groups. Conclusion. In children and adolescents with respiratory tuberculosis, Diaskintest of 0.2 µg/ml and the Mantoux test with 2 TU PPD-L have high sensitivity (98%) at a cut-off of 5 mm; however, at cut-off ≥ 15 mm sensitivity is significantly reduced, and the decrease is more pronounced in the Mantoux test. The advantage of Diaskintest is that, unlike the Mantoux test, it has high specificity under the conditions of mass BCG vaccination. The test is cost-effective, simple to carry out, and can be used in mass screening. ≥ 100 per 100,000 population [2,3]. Due to the low specificity of 3the Mantoux test, the high frequency of false positives due to cross-sensitization with the BCG vaccine strain (Mycobacterium bovis BCG) -difficulties arise in interpreting it. [4,5].An important stage in improving the methods of diagnosis of tuberculosis was the possibility of studying and deciphering the genome of tuberculosis mycobacteria, which allowed to identify the differences between M. bovis BCG vaccine strain and Mycobacterium tuberculosis virulent strains. In particular, in M. tuberculosis genome, a region of difference (RDI) was discovered, which contains genes that code for the secretion of CFP10 and ESAT6 proteins.These proteins are expressed on the surface of the mycobacterial cell upon its multiplication and determine the virulent prope...

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The objective of the study: to establish specific parameters for formation of tuberculosis risk group in HIV positive children of 0-17 years old in order to plan tuberculosis prevention activities.Subjects and methods. The main statistical rates on tuberculosis, HIV infection and their combination in children of 0-17 years old for 2009-2018 were studied. All new cases of TB/HIV co-infection were analyzed in children of 0-17 years old in Moscow for 2004-2018.Results. While the incidence of tuberculosis and HIV infection among children has been decreasing in Moscow over a 10-year period (2009-2018), the group with advanced risk to develop tuberculosis due to HIV infection is growing, both due to children born by HIV positive women (by 1.8 times), and children with confirmed HIV infection (by 2.1 times), which is partly explained by intensive migration in the big city.In the structure of the followed up of children with HIV infection, it has been established that the number and proportion of the following categories tend to grow: children above 8 years old; those at the stage of secondary diseases and advanced stages of HIV infection; and migrants from other regions.In 2004-2018, the combination of tuberculosis and HIV infection was detected most often among children aged 8-11 years (14/34; 41.2%), who had not previously been tested for HIV infection, and among people who had lived outside of Moscow before the disease was detected (16/34; 47.1%). The most severe forms of HIV/TB co-infection including fatal ones, were also observed among children from the migrant population without regular medical follow-up.