Abstract
The objective of the study : to investigate the parameters of the course of tuberculosis in the suspected source of infection and children who developed tuberculosis after exposure to the infection for different periods of time. Materials and subjects: totally 136 household nidi of tuberculous infection. Three groups of children were identified with different period of staying in the nidus of infection prior to detection of the disease in a child: Group 1 (33 nidi) – duration of exposure for 6 months and less; Group 2 (67 nidi) – duration of exposure from 6 months to 2 years; Group 3 (36 nidi) – duration of exposure for more than 2 years. The age of children varied from 3 to 14 years old. The sources of infection (136 persons) were patients with bacillary excretion with different results of drug susceptibility tests. Results. The longer the patients who were the sources of the infection suffered from tuberculosis, the bigger the portion of fibrous cavernous tuberculosis and MDR/XDR TB was: Group 1 – 6.1 and 36.4%; Group 2 – 29.8 and 53.7%; Group 3 – 66.1 and 63.9%. The course of the disease in the children from the compared groups was identical. Regardless of the duration of exposure, the most frequent forms were tuberculosis of chest lymph nodes and focal tuberculosis. Group 1 – 36.4 and 30.3%; Group 2 – 52.2 and 37.3%; Group 3 – 33.3 and 36.1%. All groups had a high level of minor forms of tuberculosis and lesions at the thickening and/or incomplete calcination phase: Group 1 – 45.5 and 51.5%; Group 2 – 82.1 and 76.1%; Group 3 – 69.4 and 63.9%. The majority of cases from Groups 1 and 2 were detected during examination through contact tracing (81.8 and 80.6%). It was observed that the quality of dispensary follow-up for contact tracing was poorer in Group 3, and due to this, confidently fewer children were detected during examination of those exposed – in 58% of cases (p 1-3 < 0,03, р 2-3 < 0,02).
Highlights
The objective of the study: to investigate the parameters of the course of tuberculosis in the suspected source of infection and children who developed tuberculosis after exposure to the infection for different periods of time
Three groups of children were identified with different period of staying in the nidus of infection prior to detection of the disease in a child: Group 1 (33 nidi) – duration of exposure for 6 months and less; Group 2 (67 nidi) – duration of exposure from 6 months to 2 years; Group 3 (36 nidi) – duration of exposure for more than 2 years
It was observed that the quality of dispensary follow-up for contact tracing was poorer in Group 3, and due to this, confidently fewer children were detected during examination of those exposed – in 58% of cases (p1-3 < 0,03, р2-3 < 0,02)
Summary
The longer the patients who were the sources of the infection suffered from tuberculosis, the bigger the portion of fibrous cavernous tuberculosis and MDR/XDR TB was: Group 1 – 6.1 and 36.4%; Group 2 – 29.8 and 53.7%; Group 3 – 66.1 and 63.9%. It was observed that the quality of dispensary follow-up for contact tracing was poorer in Group 3, and due to this, confidently fewer children were detected during examination of those exposed – in 58% of cases (p1-3 < 0,03, р2-3 < 0,02). For citations: Gubkina M.F., Khokhlova Yu.Yu., Yukhimenko N.V., Petrakova I.Yu., Sterlikova S.S., Evseeva N.I. Description of the course of tuberculosis in the sources of infection and children who developed tuberculosis after exposure to the infection for different periods of time. Вероятность заболевания туберкулезом детей, проживающих в очаге инфекции, крайне высока и зависит от эпидемиологической характеристики очага туберкулеза [5, 7, 11]. Это может быть реализовано только в том случае, если удается качественно и в полной мере провести все противоэпидемические мероприятия в очаге инфекции, включающие: разобщение контактных лиц с ИИ, проведение превентивной химиотерапии контактным лицам и регулярное их обследование (2 раза в год), проведение эффективной химиотерапии у ИИ, выполнение санитарно-просветительской работы и дезинфекции в очаге туберкулеза [2, 4, 6, 10, 12]. Цель исследования: изучение характеристики туберкулезного процесса у ИИ и у заболевших детей при различной продолжительности контакта
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