TUBERCULIN DIAGNOSTICS: TO BE OR NOT TO BE?

Abstract

Tuberculin diagnostics — is a diagnostic method of detection of specific sensitization to Mycobactrerium tuberculosis (MBT). It is used as a specific test during mass population screening on tuberculosis (mass tuberculin diagnostics) and for individual examinations (individual tuberculin diagnostics). The aims of the mass diagnostics are: revealing of the patients contaminated with MBT for the first time; revealing of the patients with hyperergic and increasing reactions to tuberculin; selection of the population for vaccination against tuberculosis with weakened BCG vaccine in infants older than 2 months of life who had not been vaccinated after birth, as well for re-vaccination with BCG vaccine; early diagnostics of tuberculosis in children and adolescents; determination of epidemiological characteristics of tuberculosis (population contamination with MBT, yearly risk of contamination with MBT). On mass tuberculin diagnostics it is used only the united intradermal tuberculin Mantoux test with 2 tuberculin units (TU) of purified tuberculin in standard solution (prepared form). In the article the author discusses questions of tuberculosis diagnostics in children and adolescents, lists indications to mass tuberculin diagnostics with Mantoux test with 2 TU PPD and test with recombinant tuberculosis allergen. Advantages of both methods, which should be used in order to increase efficacy of tuberculosis diagnostics among children population, are described. It was concluded that switch to the mass screening of tuberculosis with the means of recombinant tuberculosis allergen is not rational under current conditions. The appropriateness of 2-steps examination (necessity of test with recombinant tuberculosis allergen after receiving a positive result of Mantoux test with 2 TU PPD) is explained.

Keywords

• children
• tuberculin diagnostics
• tuberculin
• recombinant tuberculosis allergen