Forms Of Active Tuberculosis Research Articles

Prevalence of Various Forms of Active Tuberculosis in Patients with Diabetes

A diabetic foot ulcer (DFU) is a persistent complication of diabetes mellitus. Diabetes is linked to a two to four-fold higher likelihood of developing peripheral arterial disease (PAD) when compared to individuals without diabetes. Objective: To determine the incidence of various forms of active tuberculosis in patients with diabetes. Methods: It was a cross-sectional study conducted at the Department of General Medicine from August 2022 to February 2023. 175 patients, including both males and females, participated in this study. Comprehensive demographic information was meticulously documented for each patient following the appropriate consent procedures. These patients had symptoms such as cough with or without phlegm, hemoptysis, persistent fever, and unexplained weight loss, and their ages ranged from 10 to 85 years. Comprehensive medical history, clinical examination, and TB screening tests were conducted and data analysis were done by SPSS version-24 for further analysis. Results: The mean age was 51.34 years with a standard deviation of 3.61. Among the patients, 107 (61.14%) were male, and 68 (38.85%) were female. The overall prevalence of active TB was 38 cases, accounting for 21.71% of the total. Among these cases, 18 were pulmonary TB, making up 47.36% of the active TB cases, while 13 were extra-pulmonary TB, constituting 34.21% of the total. Additionally, 5 cases were identified as multidrug-resistant TB, representing 13.15% of the active TB cases. Conclusions: In conclusion, our study reveals a higher prevalence of various forms of active tuberculosis in patients with diabetes with pulmonary tuberculosis accounting for 47.35% and extra pulmonary tuberculosis for 34.21% of cases.

Cutaneous tuberculosis presenting as abdominal wall cellulitis: a case report

Tuberculosis (TB) continues to be a prevalent disease worldwide; according to World Health Organization (WHO), children and young adolescents represent about 11% of all people with TB globally. Although TB often is cited as a disease that commonly occurs in underdeveloped countries, the evolution of drug-resistant forms of TB and infection sensitivity of immunocompromised individuals have made this disease as a focal point for developed countries as well. Although pulmonary TB is the most common form worldwide, but TB can infect any organ of the body. An uncommon version- cutaneous TB- affects <2% of all individuals with active form of TB. This case report describes a 4-month-old child who presented to us with abdominal wall cellulitis following a history of fall related injury. Incision and drainage of the pus from the fluctuant area grew acid fast bacilli on Zeihl-Neelsen staining. After the child didn’t show any improvement with intravenous antibiotics, empirical anti-tuberculosis therapy was initiated after which there was marked improvement. Cutaneous TB constitutes a very small percentage of extra-pulmonary tuberculosis and is rarely seen in paediatric age group.

Frequency of Newly Diagnosis Patients of T2DM and COPD in the Department of Pulmonology at HMC Hospital Peshawar a Qualitative, Cross-Sectional, and Observational Study

Background: Since the immune system weakens in people with DM, Tuberculosis is one of the most prevalent infectious diseases . Objective: This study aimed to determine the prevalence of various forms of active Tuberculosis among people with diabetes. Methodology: This Cross-sectional, observational, and qualitative methods were use din this investigation. Patients with diabetes whom et the inclusion criteria (cough with or without expectoration, hemoptysis, persistent fever, and unexplained weight loss) were questioned in one of three pulmonology department outpatient clinics (OPDs). The short duration of diabetes, ageless than ten and more than 85 years, and all cases of immune compensation and secondary diabetes were excluded. When looking in to the possibility of TB, a thorough history, clinical exam, and tests were performed once permission was obtained. All of the information was loaded into SPSS version 24 for further analysis As a result, 151 people were chosen for further testing for TB out of a total of 550 patients questioned. Active TB was found in just 19 individuals (13percent).The mean age was5 2.03±10.01,the male-to-female ratio was01.08:01.04,and the mean duration of diabetes observed was 10.04years. All were type 2 diabetics exception which turned out to be type 01. Out of the total cases of Tuberculosis, 54% were determined to be pulmonary cases and45% were extrapulmonary cases. Pulmonary cancer had an 11% primary rate, an 18% secondary rate, and a 6% milliary rate. Smear positivity was identified in 57% of patients, and multidrug-resistant Tuberculosis was discovered in 21%, about twice the rate seen in non-diabetic cases. Results: As a result, 151 people were chosen for further testing for TB, and 550 patients were questioned. Active TB was found in just 19 individuals (13 per cent). The mean age was 52.03 ±10.01, the male-to-femaleratiowas01.08:01.04,and the mean duration of diabetes observed was 10.04 years. All were type 2 diabetics except one which turned out to be type 01. Out of the total cases of Tuberculosis, 54% were determined to be pulmonary cases and 45% were extra pulmonary cases. Pulmonary cancer had an11%primary rate,and 18% secondary rate, and a 6%milliaryrate.Smear positivity was identified in 57% of patients, and multidrug-resistant Tuberculosis was discovered in 21%,about twice the rate seen in non diabetic cases. Conclusion: Tuberculosis frequency is more prevalent in people with diabetes than in the general population. Extrapulmonary Tuberculosis occurs more often in people with diabetes compared to those without the disease. Diabetics should be screened more often for the illness so that MDR-TB doesn't spread and become a major public health issue in this underdeveloped nation. Keywords: Diabetes, pulmonary Tuberculosis, extra-pulmonary Tuberculosis, tuberculosis variants, drug-resistant Tuberculosis

Development and application experience of the clinical and organizational management algorithm for tuberculosis medical care at the regional level

Relevance. The high incidence, prevalence and mortality in tuberculosis determines the relevance of improving clinical and organizational processes in terms of algorithmization. The aim of the study was to develop and evaluate the effectiveness of the clinical and organizational management algorithm for tuberculosis medical care at the regional level. Materials and Methods. The object of the study (2007-2021) were the tuberculosis medical care system of the Sverdlovsk region, Russian Federation. The scientific and methodological bases were Department of Health Organization, Drug Supply, Medical Technologies and Hygiene of the Peoples’ Friendship University of Russia topic SRW № 214791-3-000. The development of the algorithm was carried out on the basis of a scientifically proven universal clinical management system. The epidemiological tuberculosis author data and of Rosstat in the Sverdlovsk region for 2007-2020 were used - general and structural morbidity, prevalence, mortality, as well as the number of 3, 4 and 6 groups of dispensary registration of patients. The efficiency of the algorithm was evaluated by the dynamics of the complex of epidemiological indicators of tuberculosis. Research methods were applied: content analysis, analytical, statistical, comparative, expert. Significance was assessed using the t-White test. Differences in the compared parameters were considered significant at p0.05. Results and Discussion. The effectiveness of the developed algorithm for managing regional tuberculosis medical care, including the components of needs analysis, systematization, automation and telecommunications, interdisciplinary integration, resource provision and performance evaluation, was confirmed by a significant decrease in the Sverdlovsk region for the period 2007-2020 general incidence by 2.05 times (from 119.9 to 51.7 per 100 thousand of the population), the incidence of children 0-14 years old by 1.48 times (from 18.7 to 12.6 per 100 thousand children of the corresponding age), prevalence in the population by 1.8 times (from 258.6 to 143 per 100 thousand of the population) and mortality from tuberculosis by 2.675 times (from 21.4 to 8.02 per 100 thousand of the population) (p0.001). The COVID-19 pandemic (2020-2021) did not worsen the epidemiological situation for tuberculosis in the region. In 2020, an active form of tuberculosis was detected in 2201 people, which is 16 % less than in 2019 (p0.05). The prevalence of epidemiologically dangerous bacillary forms of the disease for the period 2019-2020 decreased by 15.4 %, from 73.2 to 61.9 per 100 thousand population (p0.05). Conclusion. Clinical and organizational management of tuberculosis medical care based on the algorithmization of scientifically evidence processes increases the effectiveness of therapeutic and preventive measures and the social and epidemiological well-being of the population.

P2X7 1513A/C loss-of-function polymorphism and active tuberculosis disease in a cohort of Egyptian population: a pilot study

BackgroundTuberculosis (TB) is a multifactorial disease, and increasing evidence shows that genetic variants in regulating genes of immune response confer susceptibility to active TB at the individual level. We aimed to identify the contribution of P2X7 receptor 1513A/C genetic polymorphisms to different clinical forms of active tuberculosis in a cohort of Egyptian population.MethodsA case–control study that enrolled 25 newly diagnosed pulmonary TB (PTB) patients by positive sputum for AFB or positive culture, 25 extrapulmonary TB (EPTB) diagnosed by pathological/bacteriological/immunological studies and 25 healthy controls. A blood sample was taken before starting of therapy for P2X7 1513A/C polymorphism genotyping using PCR-restriction fragment length polymorphism.ResultsFifty-two percent of the participants were in the third decade with equal gender distribution. P2X7 receptor 1513AA (homozygote wild), AC (heterozygote) and CC (homozygote mutant) genotypes were identified. AC and CC genotypes distribution were significantly more frequent in the active TB cases (either PTB or EPTB) rather than controls (p < 0.05). Further, P2X7 1513A/C genotypes’ distribution did not associate with old TB or gender (p > 0.05), but significantly associated with history of smoking (x2 trend analysis p = 0.036).ConclusionsThere is positive association between P2X7 receptor 1513A/C polymorphism and active tuberculosis in the Egyptians.

Quality of life in children with latent tuberculosis infection

The number of children newly infected with Mycobacterium tuberculosis continues to increase. Children from foci of tuberculosis infection are most often susceptible to primary infection. In recent years, the number of children diagnosed with latent tuberculosis infection has tended to increase. It is also important that the detection of active tuberculosis also continues to grow among such children.Objective. To establish the role of risk factors and identify deviations in the quality of life in children with latent tuberculosis infection living in the foci of tuberculosis infection.Characteristics of children and research methods. The researchers examined 110 children aged 0-14 years. They analyzed the risk factors for infection with Mycobacterium tuberculosis. The effectiveness of BCG vaccination was assessed by the presence and size of the scar. The quality of life was determined using the PedsQL questionnaire version 4.0 for children of 0-14 years old.Results and discussion. There were much more children whose mothers suffered from tuberculosis in the family. There were much more children whose mothers released bacteria as compared to the children whose mothers did not excrete mycobacterium tuberculosis. The patients with an infiltrative form of pulmonary tuberculosis were the predominant source of infection in children. The children with diagnosed active tuberculosis with a history of latent tuberculosis infection were in close contact with a family member who had previously been in the penitentiary zone, and also had unsatisfactory living conditions.Conclusion. The presence of an active form of tuberculosis in a child creates the preconditions for a comprehensive deterioration of all parameters of the life quality, while latent tuberculosis infection has an adverse effect only on certain aspects of the life quality. Psychosocial functioning is most commonly affected.

Epidemiological trends in tuberculosis in Ukraine at the beginning of the COVID­-19 pandemic

Objective — to examine the tendencies of the epidemiological situation on tuberculosis in Ukraine at the beginning of the COVID-19 pandemic in 2020. &#x0D; Materials and methods. The analysis of the data of official statistics in 2015—2020, a survey of 157 medical experts and a telephone questionnaire survey of 69 residents of the Volyn region.&#x0D; Results and discussion. It was established that the disease of COVID-19 has found its imprint on the epidemiological situation of tuberculosis and on the functioning of the TB care service. In 2020, the rate of decline in the incidence of pulmonary and extrapulmonary tuberculosis was significantly more intensive than in previous years. However, the incidence of tuberculosis among contacts with bacterial excretion in tuberculosis foci increased 1.85 times in each year. The frequency of tuberculosis recurrences is steadily decreasing.The prevalence and mortality from all forms of active tuberculosis among the entire population of Ukraine has a tendency similar to a decrease in morbidity.The effectiveness of treatment of patients of all categories is proportional to the severity of the tuberculosis process, but still insufficient. Mortality in TB care institutions increased in the previous year against the decrease of this indicator in previous years. Against the background of the inaccessibility of the population to TB care, day hospitals are underused, and the sanatorium network needs to be reorganized. The surgical method of treatment of patients is extremely insufficiently realized.&#x0D; Conclusions. The dispensary contingent of TB care institutions is decreasing every year. There is a reduction in the infrastructure of the TB care service, and in each year, the largest reduction was in the bed stock of TB care institutions and sanatoriums, as well as a decrease in the number of TB doctors.

Analysis of the main epidemiological parameters of morbidity with tuberculosis of children and adolescents of the Ryazan region in 2010–2019

AIM: This study aimed to identify the main trends of the epidemiology of tuberculosis in children and adolescents in the Ryazan Region (RR) by analyzing the main epidemiological parameters of morbidity in 20102019.&#x0D; MATERIALS AND METHODS: The morbidity of children and adolescents with tuberculosis in the RR was subjected to retrospective epidemiological analysis. The data of the official and reporting documentation of the Ryazan Regional Clinical Antituberculosis Dispensary and the materials of the state reports of Territorial Administration of Rospotrebnadzor (On the Condition of SanitaryEpidemiological WellBeing of Population) in 20102019 were used. The main epidemiological parameters of morbidity due to tuberculosis were calculated using mathematical methods.&#x0D; RESULTS: The proportion of children and adolescents in the structure of morbidity due to tuberculosis in the RR in 20102019 decreased by 3.9 times and reached 6.09% in 2019. The morbidity caused by the active form of tuberculosis in children (014 years) and adolescents (1517 years) evidently declined by -20.7% and -11.5%, respectively. In children, respiratory tuberculosis predominated (55%100%), and the leading clinical form was tuberculosis in intrathoracic lymph nodes (77%). In adolescents, only pulmonary tuberculosis was identified, and focal tuberculosis was the predominating clinical form (43%). In the study period, the highest morbidity in children was recorded at the age of 714 years. No cases of mortality among children and adolescents with tuberculosis were recorded in 20102019. In 20182019, the primary infection and the risk of infection among children under 14 years of age increased from 1.3% (2018) to 1.8% (2019) and from 2.6% (2018) to 3.3% (2019), respectively. This result might indicate that morbidity due to tuberculosis increased. The majority of ill children and adolescents were identified among vaccinated ones, suggesting that the protective properties of the vaccine were insufficient (80%).&#x0D; CONCLUSION: The morbidity of children and adolescents with tuberculosis decreased, and this decrease directly associated with the general improvement in the status of tuberculosis in the country; in particular, tuberculosis foci in the RF decreased by 2.2 times [4]. In the study period, the morbidity of children (014 years) decreased by 3.5 and 2.1 times in the RR and RF, respectively. The morbidity of adolescents (1517 years) decreased by 3.1 and 2.2 times in the RR and RF, respectively. The mortality of children and adolescents in the RP was 0.0 per 100,000 population of the given age groups. In the RF, their mortalities reduced by 6.5 and 1.6 times, respectively [4].

Distinct blood transcriptomic signature of treatment in latent tuberculosis infected individuals at risk of developing active disease

Although only a small fraction will ever develop the active form of tuberculosis (ATB) disease, chemoprophylaxis treatment in latent TB infected (LTBI) individuals is an effective strategy to control pathogen transmission. Characterizing immune responses in LTBI upon chemoprophylactic treatment is important to facilitate treatment monitoring, and thus improve TB control strategies. Here, we studied changes in the blood transcriptome in a cohort of 42 LTBI and 8 ATB participants who received anti-TB therapy. Based on the expression of previously published gene signatures of progression to ATB, we stratified the LTBI cohort in two groups and examined if individuals deemed to be at elevated risk of developing ATB before treatment (LTBI-Risk) differed from others (LTBI-Other). We found that LTBI-Risk and LTBI-Other groups were associated with two distinct transcriptomic treatment signatures, with the LTBI-Risk signature resembling that of treated ATB patients. Notably, overlapping genes between LTBI-Risk and ATB treatment signatures were associated with risk of progression to ATB and interferon (IFN) signaling, and were selectively downregulated upon treatment in the LTBI-Risk but not the LTBI-Other group. Our results suggest that transcriptomic reprogramming following treatment of LTBI is heterogeneous and can be used to distinguish LTBI-Risk individuals from the LTBI cohort at large.

Types of constitutional diatheses in children with tuberculosis infection

Diathesis or constitutional abnormality is a polygenically inherited tendency of an organism to diseases, objectively recognized by deviations from the normal phenotype. There are 4 types of diatheses: exudative-catarrhal, lymphatic-hypoplastic, neuro-arthritic and allergic. The aim of the work was to identify and determine the frequency of diathesis in children with different course of tuberculosis infection. 225 children aged from 1 to 14 years were examined: 108 children with active forms of tuberculosis; 54 children with residual post-tuberculosis changes; 63 children with latent tuberculosis infection. It was found that among patients with active tuberculosis, children with lymphatic-hypoplastic (17.6 ± 3.7%) and neuro-arthritic diathesis (16.7 ± 3.6%) are most common, and children with allergic diathesis (11.1 ± 3.0% of cases) are less common. Children with lymphatic-hypoplastic diathesis often develop a complicated course of tuberculosis (26.3 ± 10.1%), there is a pronounced intoxication syndrome (58.0± 11.3%). The frequency of occurrence of children with allergic diathesis is higher in patients with residual post-tuberculosis changes (29.6 ± 6.2%) and with latent tuberculosis infection (33.3 ± 6.0%) than in patients with active tuberculosis (11.1 ± 3.0%).

Prevalence of tuberculosis among perinatally exposed to HIV and HIV-infected children and predictors of its development

Purpose of the study. To establish risk factors for tuberculosis (TB) in children perinatally exposed to HIV and HIV-infected for the development of corrective measures.Materials and methods. Outpatient records (form No. 025/y) of 216 children perinatally exposed to HIV and 121 children with HIV infection and their parents (281 individuals) were analyzed. The control group consisted of 100 healthy children. Epidemiological (descriptive, evaluative and analytical) and statistical research methods were used in the study.Results. The likelihood of contact with a patient with an active form of TB was significantly higher in perinatally exposed to HIV and HIV-infected children compared to children in the control group (p 0.001). The risk of TB in HIV-exposed children was 5.3 times higher in foci where both parents were HIV-infected than in foci formed by discordant couples (RR = 5.3; 95% CI 1.7–21.7). Children in study groups who were not vaccinated with BCG had the highest risk of TB compared to children in the control group (RR = 1.9; 95% CI 1.6–2.2).Conclusion. Risk factors for TB in children perinatally exposed to HIV are untimely vaccination against TB or its absence and living in the foci where both parents are HIV-infected. The predictors of the development of TB in HIV-infected children are household contacts with TB patient , late diagnosis of HIV infection, and late prescription of highly active antiretroviral therapy after the formation of severe immunosuppression.

Jurisdictional Control in the Sphere of Public Health Protection in the Russian Federation

The article is devoted to the issues of mandatory judicial control over acts of subjects endowed with state powers in the field of medical activity. In particular, we consider the judicial and administrative practice of resolving administrative legal disputes in connection with instituting administrative action in the field of public health protection. The current Code of Administrative Judicial Procedure (CAJP) of the Russian Federation combines the legal procedures previously included in separate regulatory acts for judicial control in the mandatory treatment of people suffering from mental illness, the active form of tuberculosis, as well as other diseases, the list of which remains open.

MEDICAL AND SOCIAL CHARACTERISTICS OF WOMEN OF YOUNG REPRODUCTIVE AGE AFTER HYSTERECTOMY

Background. In many countries, hysterectomy is one of the most frequently performed surgical procedures.The objective of our analysis was to assess the social and medical characteristics of young reproductive-age patients who underwent hysterectomy.Materials and methods. A retrospective study involved 140 women aged 18–35 years (median age 29.4 ± 4.7 years) who underwent emergency or elective hysterectomy in the hospitals of Zabaykalsky Krai for a period of 5 years (January 1, 2013, to December 31, 2017).Results. 51.4 % of patients were housewives; 52.9 % were single; 55.7 % had bad habits (smoking, alcohol consumption). These women had a high incidence of socially significant infections: HIV – 3.6 %, active forms of tuberculosis – 1.5 %. 89.3 % of hysterectomies were emergent and 10.7 % were elective (p = 0.0001; OR = 69.4; 95% CI 32.6–148.1). The indications for the emergency hysterectomy were uterine myoma (80 %) and cervical or ovarian cancer (20 %). The obstetrical complications were the main indications for the emergency surgery: placenta abruption – 24.0 %; placenta previa – 20.8 % (placenta increta and/or percreta – 16.8 %; massive antenatal bleeding – 4.0 %); postpartum hemorrhage after vaginal delivery and caesarean section 19.2 %; septic and/or hemorrhagic shock in early miscarriages (from 8 to 19 weeks of gestation) 15.2 %. Mortality was registered in case of emergency hysterectomy only (4.3 %). Half of the deaths (50 %) occurred in cases of complicated miscarriages.Conclusion. To preserve the reproductive potential of young women of reproductive age, it is necessary to increase their social and cultural level, and responsibility for their own health and gender behavior.

Tratamiento de la tuberculosis

Specific medication against the causative agent is the basis of treatment and is indicated in all active forms of tuberculosis, regardless of the extent and location of the disease. In the case of pulmonary tuberculosis, the elements that can guide the diagnosis of activity are the symptoms (which may be absent), the radiological appearance of the exudative or productive infiltrations, the presence of caverns, and, above all, the finding of the bacillus.&nbsp; &nbsp

Anomalies of the Constitution and Tuberculosis Infection in Children

Phenotypical implications of genetic features are anomalies of the constitution or diathesis. A research objective children had an identification with a tuberculosis infection of occurrence of diathesis. 222 children aged from 1 year up to 14 years are examined: 106 children with active forms of tuberculosis; 54 children with residual post-tubercular changes; 62 children infected with MBT. Limfatiko-hypoplastic, allergic, neuroarthritic, exudative and catarral diathesis was taped. Children with limfatiko-hypoplastic (17.0 ± 3.7%) and neuroarthritic diathesis most often occur among patients with active tuberculosis (17.0 ± 3.7%), children with allergic diathesis are more rare (10.4 ± 3.0% of cases. The least favorable current of active forms of tuberculosis became perceptible at children with limfatiko-hypoplastic diathesis: the complicated forms of tuberculosis became perceptible at them in 27.8 ± 10.6% of cases. At patients with neuroarthritic diathesis the complicated forms developed less often - in 11.1 ± 7.4% of cases. Children with allergic diathesis transferred only uncomplicated forms of primary period of tuberculosis. At children without anomalies of the constitution the complicated current was observed often - in 27.6 ± 5.9% of cases. Frequency of occurrence of children with allergic diathesis is higher at patients with residual post-tubercular changes (29.6 ± 6.2%) and the infected MBT (33.8 ± 6.1%), than at patients with active tuberculosis (10.4 ± 3.0%). Existence of a certain anomaly of the constitution in many respects predetermines the course of a tuberculosis infection.

Biodegradable Polymer Nanoparticles of Anti-Tubercular Drug: Formulation and In Vitro Release Studies

Tuberculosis (TB), has been a serious global health problem, resulting in millions of deaths annually. In India itself, 40% of the population are having Latent TB infection and approximately 10% of infected individuals have higher risk of developing active disease, especially those who are immune compromised like HIV infected and patients on immune suppressants.The Latent TB evolves through different stages to become active disease, hence treating latent infection has better scope in controlling TB. Current TB treatment poses several problems and also leads to emergence of drug resistance strains. The biodegradable nanoparticles are promising drug carriers as it has high stability, less toxic and can release the drug in sustained manner. The objective is to provide a new mode of drug delivery through nanoparticles (NP) incorporated with current anti-tubercular drugs that could solve issues with current drug treatment regimen and make available for treatment of latency and active form of TB in long term. In the present study, single emulsion solvent evaporation method was used to formulate and optimize front line anti-tubercular drug with the polymer Poly (lactic co-glycolic acid) PLGA, which is biocompatible and biodegradable. Characterization studies and determination of drug loading efficiency were studied to know the effect of formulation variables. In vitro drug release study was conducted and reverse phase high pressure liquid chromatography method (RP-HPLC) was developed for the analysis of drug. Hence, optimized PLGA, nanoparticles loaded with anti-tuberculosis drug (ATD) have shown good encapsulation efficiency and drug release profile resulted slow and sustained release over a period of several days. In order to target therapeutic molecules, the biodegradable Nano particulate carriers has the potential for improving the efficacy of TB treatment.

Smear positivity in paediatric and adult tuberculosis: systematic review and meta-analysis

BackgroundTuberculosis (TB) diagnosis continues to rely on sputum smear microscopy in many settings. We conducted a meta-analysis to estimate the percentage of children and adults with tuberculosis that are sputum smear positive.MethodsWe searched PubMed, MEDLINE, Embase, and Global Health databases for studies that included both children and adults with all forms of active TB. The pooled percentages of children and adults with smear positive TB were estimated using the inverse variance heterogeneity model. This review was registered in the PROSPERO database under registration number CRD42015015331.ResultsWe identified 20 studies meeting our inclusion criteria that reported smear positivity for a total of 18,316 children and 162,574 adults from 14 countries. The pooled percentage of paediatric TB cases that were sputum smear positive was 6.8 % (95 % Confidence Interval (CI) 2.2–12.2 %), compared with 52.0 % (95 % CI 40.0–64.0 %) among adult cases. Eight studies reported data separately for children aged 0–4 and 5–14. The percentage of children aged 0–4 that were smear positive was 0.5 % (95 % CI 0.0–1.9 %), compared with 14.0 % (95 % CI 8.9–19.4 %) among children aged 5–14.ConclusionsChildren, especially those aged 0–4, are much less likely to be sputum smear positive than adults. National TB programs relying on sputum smear for diagnosis are at risk of under-diagnosing and underestimating the burden of TB in children.Electronic supplementary materialThe online version of this article (doi:10.1186/s12879-016-1617-9) contains supplementary material, which is available to authorized users.

The comparison of laboratory tests Quantiferon, Tubinferon and Diaskintest in children with tuberculosis infection.

The study was carried out to compare results of three tests on the basis of antigens CFP-10 and ESAT-6: laboratory tests QuantiFERON (QFT) and Tubinferon (TIF) and intra-cutaneous test with allergen tuberculous recombinant - Diaskintest (DST). Tubinferon is a Russian analog of test QuantiFERON and is based on quantitative analysis of interferon-gamma after incubation of samples of whole blood in the presence of antigens of Mycobacterium tuberculosis (MBT) - tuberculin and recombinant antigens ESAT-6 and САЗ-10. The results QFT, TIF and DST are examined on 63 patients aged from 7 months to 15 years at parallel setup. According complex examination 63 children were divided at three groups: group I - 29 children infected with MBT and without disease; group II - 8 children non-infected with MBT; group III - 26 children with active forms of tuberculosis. It is established that at high rate of coincidence of results of all three tests (68.3%) in particular situations they can react differently, providing thereby additional information. The results of tests QFT and TIF coincide in 74.6% of all cases. The tests in vitro (QFT, TFT) occurred more sensitive under immuno-pathologic conditions in comparison with DST test. The TFT test demonstrated higher sensitivity under infection with MBT (58.6%) as compared with DST (34.5%) and QFT (34.5%) but lesser than in children with tuberculosis: TFT - 61.5%, QFT - 92.3%, DST - 80.8%. The conclusion is made that all three tests provide positive result more often under tuberculosis infection than in case of infected with MBT. The Tubinferon test is recommended to application and especially for children infected with MBT prior development of disease.

Oral bacillus Calmette-Guérin vaccine against tuberculosis: why not?

The bacillus Calmette-Guérin (BCG) vaccine is the only licensed vaccine for human use against tuberculosis (TB). Although controversy exists about its efficacy, the BCG vaccine is able to protect newborns and children against disseminated forms of TB, but fails to protect adults against active forms of TB. In the last few years, interest in the mucosal delivery route for the vaccine has been increasing owing to its increased capacity to induce protective immune responses both in the mucosal and the systemic immune compartments. Here, we show the importance of this route of vaccination in newly developed vaccines, especially for vaccines against TB.

О вакцинации подростков против туберкулеза

The questions of vaccination and revaccination with BCG vaccine, mass screening of children and adolescents with Mantoux test in order to reveal risk groups for development of active tuberculosis and further individual diagnostics among such patients are discussed in this article. The data on efficacy of vaccination against tuberculosis in the Russian Federation are covered. The authors represented information on negative experience of the cancellation of the revaccination against tuberculosis in the Republic of Belarus which led to increase of tuberculosis prevalence. The characteristics of the immune response during adolescence due to the risk of tuberculosis development are considered. It was concluded that special features of the adolescents immune system, negative experience of the Republic of Belarus on cancellation of BCG revaccination at the age of 14 years old, refusals of the adolescents noninfected with mycobacteria to undergo second revaccination with BCG at the age of 14 years old can lead to increase in active forms of tuberculosis among adolescents. Under the conditions of the increasing resistance of mycobacteria to antituberculous agents this is fraught with lethal outcomes.