Бюллетень сибирской медицины (Jan 2017)

Comparative evaluation of immunological tests for at-risk children in Tomsk Region

  • N. N. Kabanets,
  • O. V. Filinyuk,
  • O. I. Urazova,
  • K. S. Morozova,
  • O. V. Kolokolova

DOI
https://doi.org/10.20538/1682-0363-2016-5-30-38
Journal volume & issue
Vol. 15, no. 5
pp. 30 – 38

Abstract

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The purpose of this paper is to compare the results of immunological tests (tests with recombinant allergen TB in standard dilution (RAT) and the Mantoux tuberculin test) in children at risk of developing tuberculosis in Tomsk Region.Materials and methods. A retrospective analysis of 1204 outpatient medical records of children and adolescents at the age from 1 to 16 was performed.Results. When two tests are carried out at the same time (skin test with RAT (Diaskin-test) and Mantoux tuberculin test), the proportion of positive reactions to tuberculin was 92,4%, including 6,6% of hyperergic reactions, while there were 6,0% of positive reactions to RAT, including 3,2% of hyperergic reactions. The biggest number of positive reactions to RAT was recorded among children with severe and hyperergic tuberculin sensitivity (28,7%) and children from tuberculosis prevalence areas (17,5%). The lowest number of positive reactions to RAT was recorded among children with conversion of tubercular tests and children with latent TB infection (LTBI) – 2,8% and 1,5% respectively.Conclusions. The results of skin tests with RAT as compared to the tests with tuberculin are different. When there is a conversion of tubercular test the positive reaction to Diaskintest was detected only in a few cases (2,8% of cases) as compared to prevailing (in 96,4% of cases) positive reaction to tuberculin; in children with severe and hyperergic results the tuberculin reaction to RAT was the same in every third child (28,7%); in children with increasing sensitivity to tuberculin the immunological response during Diaskintest was detected in 4,7% of cases.More often local forms of tuberculosis were detected among children with hyperergic reactions to skin tests with RAT (12 of 38 children, 31,6%), χ2 = 306,3; p <0,001, and when there is an overlap of hyperergic results of two immunological tests (6 of 15 children, 40,0%) χ2 = 303,5; p <0,001

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