Cutaneous Immunological Tests for the Diagnosis of Tuberculosis Infection in Children and Adolescents (Analytical Review)

Овсянкина, Е. С.; Губкина, М. Ф.; Панова, Л.В.; Юхименко, Н. В.

doi:10.31631/2073-3046-2016-15-2-26-33

Epidemiology and Vaccine Prevention

2016

DOI: 10.31631/2073-3046-2016-15-2-26-33

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Cutaneous Immunological Tests for the Diagnosis of Tuberculosis Infection in Children and Adolescents (Analytical Review)

Е. С. Овсянкина¹,

М. Ф. Губкина²,

Л.В. Панова³

et al.

Abstract: Early detection and diagnosis of tuberculosis (TB) infections are one of the most urgent problems of childhood TB, as it is based mostly on a set of attributes (epidemiological, clinical, radiological, laboratory) due to lack of the possibility of obtaining diagnostic material for microbiological examination for the majority of patients. Immunological skin tests play an important role in this process as an opportunity to define the formation of high-risk groups for TB, followed by additional methods of inspect… Show more

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Cited by 3 publications

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Directive and guidance documents on the use of skin immunological tests for screening tuberculosis infection in children and adolescents: phthisiologist's review and comments

Ovsyankina

Панова

2022

Medicinskij sovet

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Skin immunological tests are the main method for detecting tuberculosis infection in children and adolescents. A Mantoux test with two tuberculin units (TU) PPD-L has been one of the most effective methods for detecting tuberculosis in the pediatric group over a period of many decades. The development of a new test - a recombinant TB allergen diagnostic test - has changed approaches to screening for tuberculosis infection in children. Today, both tests are used but with differentiation according to the age category of children (Mantoux test - from 1 year to 7 years, recombinant tuberculosis allergen - from 8 to 17 years). This approach was enshrined in the current directive and guidance documents in 2014. However, there is no single document that could serve as a desk book on this issue for a paediatric practitioner. Moreover, the article presents one of the most difficult issues that require knowledge of the relevant legislation and ability to conduct health education work on the part of the practitioners - the legal aspects of tuberculosis immunodiagnosis in children and adolescents in case of refusal of skin immunological testing. The low health and sanitary literacy regarding tuberculosis and its prevention in the population can also be viewed as a result of the use of mass media on the issue by non-professionals. It should be noted that some of the documents are published on the website of the Russian Society of Phthisiologists as guidance manuals and clinical recommendations, which are overlooked by practitioners of general medical institutions. The summation of directive and guidance documents on all issues of the use of skin immunological tests with comments is aimed at enhancing knowledge and, accordingly, the effectiveness of their use.

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Directive and guidance documents on the use of skin immunological tests for screening tuberculosis infection in children and adolescents: phthisiologist's review and comments

Ovsyankina

Панова

2022

Medicinskij sovet

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Immunodiagnostics of tuberculosis infection <i>in vitro</i> in solving the issue of prescribing preventive chemotherapy

et al. 2020

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For the immunodiagnosis of tuberculosis infection, in addition to standard skin tests (Mantoux test with 2 TU PPD-L and Diaskintest), in vitro tests are currently used, one of which is the T-spot.TB test. Purpose of research. Evaluate the T-SPOT test as a method of early detection of tuberculosis infection in children and adolescents and its role as an additional method in solving the problem of the need for chemoprophylaxis. Materials and methods. The analysis of the results of T-SPOT.TB in 794 children aged 2 to 17 years inclusive in the period from 2016 to 2019 was carried out. Two groups were allocated: 1 group (n = 596)-children who underwent T-SPOT.TB as the main methodology; Group 2-198 children with positive skin test results for a recombinant tuberculosis allergen after screening. The results of T-SPOT.TB were evaluated taking into account the data of previous immunodiagnostics and associated pathology. Results. It is established that T-SPOT.TB. can be used as an independent method in case of rejection of skin tests. The level of latent tuberculosis infection is higher among children with concomitant pathology according to the results of T-SPOT.TB twice. Conclusion. T-SPOT.TB can be an alternative method for diagnosing tuberculosis infection during screening. In children with concomitant pathology of the T-SPOT.TB can serve as the leading method of tuberculosis immunodiagnosis. A positive T-SPOT.TB can serve as an additional method for deciding on the appointment of preventive chemotherapy.

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Retrospective evaluation of the results of immunodiagnostics for tuberculosis in children

Volkova,

Mikheeva,

Melnikova

et al. 2024

Journal of microbiology, epidemiology and immunobiology

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Introduction. For early immunodiagnostics of tuberculosis (TB) in Russia, the Mantoux test (MT) has been used for decades; since 2013, the recombinant tuberculosis antigen (RTA) test has seen widespread use. The objective of this retrospective analytic observational cohort study was to evaluate the results of immunodiagnostics for TB in children with newly diagnosed active TB. Materials and methods. We studied data from Russian TB institutions on the results of MT and RTA assay in children with active and inactive TB first detected in 2013–2018, as well as children with active TB first detected in Moscow in 2017–2022. Results and discussion. In 2013–2018, out of 12,902 examined children with active TB, 11,673 (90.5%) had positive results of both skin tests and 198 (1.5%) had negative results. A negative RTA assay result with positive MT was found in 861 (6.7%) patients, and a positive RTA assay result with negative MT in 170 (1.3%). The sensitivity of the RTA assay in detecting active TB was 91.3%, while the sensitivity of MT was 97.2% (p 0.01). Similar data were obtained in the same regions in 14,127 children with inactive TB: the sensitivity of MT was higher than that of the RTA assay — 97.2% versus 95.2% (p 0.01). In Moscow, due to the small number of observations in 2022, it was not possible to show statistical reliability of the difference between the sensitivity of MT and RTA assay in detecting active TB in 2017–2022 (95.8% and 92.1% respectively; p 0.5). For the results obtained in 2017–2021, the difference was significant (p 0.05). Conclusion. The sensitivity of MT is higher than that of the RTA assay in screening children for TB. It is recommended to use the more sensitive MT test for screening children; screening with the RTA assay will increase the number of undetected and undiagnosed cases of active TB in children. Currently, MT cannot be excluded from the algorithm of early TB diagnosis in children.

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Cutaneous Immunological Tests for the Diagnosis of Tuberculosis Infection in Children and Adolescents (Analytical Review)

Cited by 3 publications

References 5 publications

Directive and guidance documents on the use of skin immunological tests for screening tuberculosis infection in children and adolescents: phthisiologist's review and comments

Directive and guidance documents on the use of skin immunological tests for screening tuberculosis infection in children and adolescents: phthisiologist's review and comments

Immunodiagnostics of tuberculosis infection <i>in vitro</i> in solving the issue of prescribing preventive chemotherapy

Retrospective evaluation of the results of immunodiagnostics for tuberculosis in children

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