Efficiency of screening for tuberculosis infection in children and adolescents in Moscow in 2019 based on the new procedure for using the intradermal test with tuberculosis recombinant allergen (ESAT-6/CFP-10)

Abstract

The objective of the study : to compare two approaches to mass screening for tuberculosis infection in children and adolescents in Moscow. Subjects and methods . Two periods have been assessed. Period 1 (2014), when a pilot screening project was implemented in two stages: Stage 1 -all children and adolescents had Mantoux test with 2 TU PPD-L (1,429,395 people were tested), Stage 2 - a skin test with TRA (tuberculosis recombinant allergen - ESAT protein-6/CFP-10) was used in those with increasing induration as a response to Mantoux test (219,888 people were tested). Period 2 (2019): children from 0 to 7 years old (711,869 children were tested) were screened by the same two-stage scheme, and those 8-17 years old (904,757 people were tested) had the test with TRA only. Results . It has been demonstrated that the test with TRA can be used as a screening tool and effectively identify patients with a high risk of tuberculosis development. At the same time, the rate of detection of tuberculosis patients, persons with post-tuberculosis changes and latent infection is tens times higher among persons with positive reactions to TRA test versus Mantoux test. The preventive therapy received by those positively responding to TRA test resulted in almost no disease in them. Over the past 7 years, the number of people newly diagnosed with tuberculosis, latent tuberculosis infection (LTBI) and post-tuberculosis changes has decreased. Preventive therapy in those with a positive result of TRA test helps to stop the progression of tuberculosis infection and reduce the pool of LTBI among children and adolescents. TRA test versus Mantoux test, allows more effective selection patients with a high risk of developing tuberculosis, thus it is possible to carry out additional examination only of this target group and save resources.