Abstract
Development of new methods of immune diagnostics of tuberculous infection and their introduction into tuberculosis control practice have changed approaches to diagnostics of tuberculosis in Russia. Along with world recognized IGRA-tests the test with tuberculous recombinant allergen (TRA) developed by Russian researchers is also widely used. High diagnostic value of each of the methods is proved by multiple national and international trials however there is no research comparing results of these methods in the diagnostics of tuberculous infection in children, including those with concurrent conditions. During the study data of testing in 654 children in the age from 0 to 14 years old with positive sensitivity to tuberculin as per Mantoux test with 2 TU were analyzed. All patients had modern immunological tests done: TRA and IGRA-tests (QuantifeRON® Gold ELISA (QFT) and T-SPOT.TB). The study confirmed the low value of Mantoux test with 2 TU as a method of early tuberculosis detection in children; it detected underdiagnosis (10-50%) and overdiagnosis (78%) of latent tuberculous infection in the children with different sensitivity level as per data of Mantoux test with 2 TU. Comparing the results of TRA and IGRA tests it is possible to state that they are compatible for 76-81% of cases. The group of children was detected who had allergic and endocrine disorders (obesity), for whom IGRA tests were recommended to exclude chances of false-positive results of TRA tests.
Highlights
Разработка новых методов иммунодиагностики туберкулезной инфекции и их внедрение во фтизиатрическую практику изменили подходы к диагностике туберкулеза в России
Исследование позволило подтвердить низкую значимость пробы Манту с 2 ТЕ как метода раннего выявления туберкулеза у детей, установить гипо- (10-50%) и гипердиагностику (78%) латентной туберкулезной инфекции у детей с различным уровнем чувствительности по данным пробы Манту с 2 ТЕ
The study confirmed the low value of Mantoux test with 2 TU as a method of early tuberculosis detection in children; it detected underdiagnosis (10-50%) and overdiagnosis (78%) of latent tuberculous infection in the children with different sensitivity level as per data of Mantoux test with 2 TU
Summary
All patients had modern immunological tests done: TRA and IGRA-tests (QuantifeRON® Gold ELISA (QFT) and T-SPOT.TB). The group of children was detected who had allergic and endocrine disorders (obesity), for whom IGRA tests were recommended to exclude chances of false-positive results of TRA tests. For citations: Starshinova A.A., Аnaniev S.M., Ovchinnikova Yu.E., Korneva N.V., Dovgalyuk I.F. Results of immunological testing of new generation in children under massive vaccination against tuberculosis. Tuberculosis and Lung Diseases, Vol 95, No 5, 2017 кулиновый тест (проба Манту c 2 ТЕ) и IGRA-тесты (QFT и T-SPOT.TB) по отдельности. В единичных исследованиях сравнивается информативность пробы с АТР и QuantifeRON-TB Gold в определении активности туберкулезной инфекции у детей. Цель исследования: улучшить раннюю диагностику туберкулеза у детей в условиях массовой вакцинации против туберкулеза путем внедрения иммунологических тестов нового поколения
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