К ВОПРОСУ О ВЫЯВЛЕНИИ ТУБЕРКУЛЕЗА ОРГАНОВ ДЫХАНИЯ У ПОДРОСТКОВ ПРИ ПРОВЕДЕНИИ ПЛАНОВОЙ ФЛЮОРОГРАФИИ: ВЗГЛЯД ФТИЗИАТРА

Abstract

The scheduled, routine fluorography does not allow detecting of the primary small forms of tuberculosis (TB) and the limited prevalence processes without bacterial excretion. The purpose of the study was to evaluate the contribution and the informative content of the scheduled fluorography as a screening method for the early detection of TB in adolescents. Materials and methods: a single-center retrospective cohort study of 142 disease history cases of adolescents admitted for treatment at the Children's and Adolescents Department with the Central Research Institute of Tuberculosis (Moscow, Russia) at the age of 15 to 17 years old, of which 74 (52.1%) were girls, and 68 (47.9%) boys, with respiratory TB. The continuous sample from 2015 to 2020, 34 (24.0%) of which were identified with the scheduled, routine fluorography. The data for inclusion in the study was obtained from medical records submitted upon admission. Results: according to the routine fluorography results, the infiltrative TB of the respiratory organs was diagnosed statistically significantly more often compared to the results of skin immunological tests: in 76.5% and 20.5% of cases, respectively, р˂0.001; the lung tissue decay in 58.8% and 15.4% of cases, respectively, p˂0.001; and the bacterial excretion in 58.8% and 5.1% of cases, respectively, p˂0.001. This indicates a high epidemic risk of patients. Conclusion: the routine fluorography in adolescents does not correspond to the concept of screening for TB infection, the essence of which is the early detection of the disease. From the authors’ point of view, the expediency of fluorography in this age group should be considered primarily as the first - and not the only - stage for diagnostic approach in the acute period of a pulmonary disease.