Results of the implementation of new methods for diagnosing tuberculosis among children in 12 regions of Ukraine

Abstract

Objective —improve the efficiency and quality of diagnosing tuberculosis (TB) in children by expanding the testing of «non-invasive» samples, developing an algorithm for integrating the potential of testing such samples into routine pediatric TB services in various settings, and mastering the skills of conducting laboratory procedures for testing fecal samples.
 Materials and methods. As part of the project «Supporting efforts to combat tuberculosis in Ukraine», implemented by the PATH organization with financial support from the United States Agency for International Development (USAID), a pilot implementation of the diagnosis of pulmonary TB in children has begun, using Xpert MTB/RIF Ultra cartridges for a fecal sample as a primary diagnostic test.At the stage of diagnosis, before starting treatment with anti-tuberculosis drugs, all children under 5 years of age were examined, as well as children under 15 years of age with a preliminary diagnosis of tuberculosis, who cannot produce sputum or who have difficulty obtaining other diagnostic material.
 Results and discussion. The intermediate results obtained are quite encouraging for the implementation of such tests throughout the country. The use of faecal samples, which do not require invasive manipulation, may have a positive impact on laboratory confirmation of TB diagnosis in the pediatric population, with 12.8 % having a positive result, and 8.5 % of studies having a positive test result only with faeces and a negative with gastric lavage.
 Conclusions. The results of the implementation of the method will help to identify and justify the necessary changes to the algorithm for diagnosing TB in children under 5 years of age or children under 15 years of age who cannot produce sputum or in case of difficulty in obtaining other diagnostic material.