Recommendations for the management of tuberculosis in children - KOMPASS TB. Part 1: Tuberculosis prevention.

Teresa Bielecka,Katarzyna Krenke,Andrzej Pustkowski,Anna Pankowska,Maria Korzeniewska-Koseła,Joanna Stryczyńska-Kazubska,Joanna Lange,Zbigniew Doniec,Paweł Gruszczyński,Paweł Gonerko,Maria Krasińska,Marek Popielarz,Ewa Augustynowicz-Kopeć

doi:10.5603/arm.2018.0023

Abstract

Since the second half of the 20th century the incidence of tuberculosis has been declining in Poland. Despite this, current epidemiological data still support the need for the continued mass BCG vaccination in Poland in the near future. Apart from the protection against severe hematogenous forms of tuberculosis, vaccination lowers the risk of infection with Mycobacterium tuberculosis. Primary and acquired immunodeficiency, including immunity disorders associated with an ongoing treatment, are contraindications to BCG vaccination. The most common adverse effects following BCG vaccination are reactions at the site of injection and in regional lymph nodes, which usually does not require treatment. Methods of tuberculosis prevention, particularly recommended in low-incidence countries, include: diagnostic investigations of patients who had contacts with pulmonary tuberculosis as well as an active detection and treatment of latent Mycobacterium tuberculosis infection. Latent tuberculosis infection can be identified on the basis of positive results of the tuberculin skin test or interferon-gamma release assays after the active disease has been ruled out. This condition does require prophylactic treatment.

Highlights

The recommendations were developed on behalf of the Polish Society of Pediatric Pulmonology and National Consultant of Pediatric Pulmonology by the group of experts — TB Team
The vaccine has been named after its creators: Albert Calmette and Camille Guerin: M. bovis BCG (Bacillus Calmette- Guerin)
Its implementation in the 1920s significantly decreased the incidence of severe hematogenous forms of tuberculosis among infants and young children and reduced mortality associated with this disease [2, 3]

Summary

Introduction

The patient must be diagnosed with immunodeficiency (cell-mediated immunity disorders, severe immunodeficiency, HIV infection), and the etiology of infection must be confirmed (bacteriological tests for M. bovis BCG in the referential tuberculosis laboratory). In accordance with the Act of 5 December 2008 on Prevention and Treatment of Infections and Infectious Diseases in Humans, individuals who come into contact with a tuberculosis patient should be under epidemiological surveillance, should undergo clinical examination and diagnostic tests or if needed, a preventive pharmacological treatment [9].

Results

Conclusion