Characteristics of tuberculosis infection in children and adolescents (local knowledge)
https://doi.org/10.21518/ms2025-182
Abstract
Introduction. TB incidence rate among children is a dynamic indicator used to describe the epidemic situation of tuberculosis. Monitoring and analysis of the epidemic situation helps improve the performance of the primary health care in the early detection of tuberculosis in children and adolescents, the formation of groups at high risk of exposure to tuberculosis and the implementation of preventive measures in these groups.
Aim. To provide a detailed analysis of the current epidemiological situation of tuberculosis among children and adolescents in the Saratov region, assess the implementation of early detection of tuberculosis in the pediatric population over a five-year observation period (2019–2023) and in high-risk groups.
Materials and methods. The statistical data on TB patients collected using Federal Statistical Observation Form No. 33 and the information presented in the annual reports from different areas of the region and Saratov city for the period from 2019 to 2023 were studied.
Results. The incidence rates in population were 3.5 times lower in 2023 compared to 2001, the incidence rates among children and adolescents decreased as follows: 8.5 times in children and 2.6 times in adolescents. The comparative analysis of the effectiveness of skin tests in the early detection of active tuberculosis in children under 14 years showed the prevailing value of Diaskintest. The analysis of TB detection methods in adolescents proves the appropriateness of TB testing done twice over the course of a year, alternating between using Diaskintest and check-up X-ray at the age of 15, 16, 17 years. The results of Diaskintest in children with medical and biological (n = 14.840) factors, as well as social risk factors (n = 3.767) were assessed. The level of latent tuberculosis infection (LTBI) in each group was 1.4% and 3.3%, respectively, which is higher than that (0.6%) in the general population of the region.
Conclusions. Monitoring TB incidence rates among children and adolescents in the Saratov region indicates sufficient performance of anti-tuberculosis program in the region. The data obtained confirm the rationale for using immunodiagnostics in adolescents as the key screening test for tuberculosis.
About the Authors
T. I. Morozova
Saratov State Medical University named after V.I. Razumovsky
Russian Federation
Russian Federation
Tatiana I. Morozova, Dr. Sci. (Med.), Professor, Head of Phthisiology Department
112, Bolshaya Kazachia St., Saratov, 410012
E. N. Aleksandrova
Saratov State Medical University named after V.I. Razumovsky
Russian Federation
Russian Federation
Elena N. Aleksandrova, Cand. Sci. (Med.), Assistant of Phthisiology Department
112, Bolshaya Kazachia St., Saratov, 410012
T. Yu. Salina
Saratov State Medical University named after V.I. Razumovsky
Russian Federation
Russian Federation
Tatiana Yu. Salina, Dr. Sci. (Med.), Professor of Phthisiology Department
112, Bolshaya Kazachia St., Saratov, 410012
D. А. Kudlay
Sechenov First Moscow State Medical University (Sechenov University);
National Research Center – Institute of Immunology Federal Medical-Biological Agency of Russia;
Lomonosov Moscow State University
Russian Federation
Russian Federation
Dmitry A. Kudlay, Corr. Member RAS, Dr. Sci. (Med.), Professor, Chair of Pharmacology, Institute of Pharmacy, Sechenov First Moscow State Medical University (Sechenov University); Professor of the Department of Pharmacognosy and Industrial Pharmacy, Faculty of Fundamental Medicine, Lomonosov Moscow State University; Leading Researcher, Laboratory of Personalized Medicine and Molecular Immunology No. 71, State Research Center Institute of Immunology, National Research Center – Institute of Immunology Federal Medical-Biological Agency of Russia
8, Bldg. 2, Trubetskaya St., Moscow, 119991,
1, Lenin Hills, Moscow, 119991,
24, Kashirskoye Shosse, Moscow, 115478
N. P. Doktorova
National Medical Research Center for Phthisiopulmonology and Infectious Diseases
Russian Federation
Russian Federation
Natalia P. Doktorova, Cand. Sci. (Med.), Research Associate, Science Division of Differential Diagnosis and Treatment of Tuberculosis and Co-infections
4, Bldg. 1, Dostoevsky St., Moscow, 127473
N. Yu. Nikolenko
Moscow Scientific and Practical Center for Tuberculosis Control
Russian Federation
Russian Federation
Nikolay Yu. Nikolenko, Cand. Sci. (Farm.), Research Associate of Farm Sciences Researcher, Scientific and Clinical Department
10, Stromynka St., Moscow, 107014
References
1. Васильева ИА, Стерликов СА, Тестов ВВ, Михайлова ЮВ, Голубев НА, Кучерявая ДА, Пономарев СБ. Ресурсы и деятельность противотуберкулезных организаций Российской Федерации в 2022–2023 гг. М.: РИО ЦНИИОИЗ; 2024. 95 с.
2. Danilov AN, Morozova TI, Doktorova NP. Dynamics of the main epidemic indicators of tuberculosis in the Saratov region. Saratov Journal of Medical Scientific Research. 2014;10(2):289–293. (In Russ.) Available at: https://ssmj.ru/system/files/2014_02_289-293.pdf.
3. Aksenova VA, Sterlikov SA, Kucheryavaya DA, Andreeva TV. Epidemic situation of tuberculosis in children in 2022. Current Problems of Health Care and Medical Statistics. 2024;(1):360–375. (In Russ.) Available at: https://healthproblem.ru/ru/magazines?textEn=1242.
4. Aleksandrova EN, Morozova TI, Salina TYu. Tuberculosis situation among the pediatric population of Saratov Region (2015—2019). Tuberculosis and Lung Diseases. 2021;99(12):33–37. (In Russ.) https://doi.org/10.21292/2075-1230-2021-99-12-33-37.
5. Аксенова ВА, Барышникова ЛА, Бармина НА, Баронова ОД, Васильева ИА, Довгалюк ИФ и др. Туберкулез у детей: клинические рекомендации. М.; 2024. Режим доступа: https://tbclinic.ru/upload/iblock/bb2/6lrdre60e2i7wx0x1qir3o283ulr141p.pdf.
6. Аксенова ВА, Барышникова ЛА, Бармина НА, Баронова ОД, Васильева ИА, Валиев РШ и др. Латентная туберкулезная инфекция у детей: клинические рекомендации. М.; 2024. Режим доступа: https://okptd55.gosuslugi.ru/netcat_files/12/191/KR_LTI_2024g.pdf.
7. Васильева ИА, Абрамченко АВ, Андронов СА, Баласанянц ГС, Батыров ФА, Богородская ЕМ и др. Туберкулез у взрослых: клинические рекомендации. М.; 2024. Режим доступа: https://www.rokptd.ru/uploads/userfiles/organization_1200/documents/klinic-recomended/tyberkylez-vzroslie-2024.pdf.
8. Morozova TI, Doktorova NP. Latent tuberculosis infection in risk groups of the adult population of the Saratov Region. Meditsinskiy Sovet. 2023;17(4):82–90. (In Russ.) https://doi.org/10.21518/ms2023-054.
9. Slogotskaya LV, Bogorodskaya E, Sentchichina O, Ivanova D, Nikitina G, Litvinov V et al. Effectiveness of tuberculosis detection using a skin test with allergen recombinant (CFP-10-ESAT-6) in children. European Respiratory Journal. 2015;46(Suppl. 59):РА4524. Available at: https://elibrary.ru/zdjlqf.
10. Slogotskaya LV, Bogorodskaya Е, Ivanova D, Makarova M, Guntupova L, Litvinov V et al. Sensitivity and specificity of new skin test with recombinant protein CFP10-ESAT6 in patients with tuberculosis and individuals with non- tuberculosis diseases. European Respiratory Journal. 2013;42(Suppl. 57):1995. Available at: https://elibrary.ru/zdlphn.
11. Slogotskaya LV, Litvinov V, Kudlay DA, Ovsyankina E, Seltsovsky P, Ivanova D, Nikolenko N. New skin test with recombinant protein CFP10-ESAT6 in patients (children and adults) with tuberculosis, non-tuberculosis disease and latent TB infection. European Respiratory Journal. 2012;40(Suppl. 56):416. Available at: https://elibrary.ru/zdiazn.
12. Aksenova VA, Baryshnikova LA, Dolzhenko EN, Kudlay DA. Tuberculosis screening in children today: important issues. Doktor.Ru. 2012;(8):27–29. (In Russ.) Available at: https://elibrary.ru/pkeeyh.
13. Kudlay DA, Doktorova NP. ESAT-6 and CFP-10 antigens as a biotechnology molecule substrate. Applications in medicine. Russian Journal of Infection and Immunity. 2022;12(3):439–449. (In Russ.) https://doi.org/10.15789/2220-7619-EAC-1763.
14. Shovkun L, Aksenova V, Kudlay D, Sarychev A. The role of immunological tests in the diagnosis of tuberculosis infection in children with juvenile idiopathic arthritis (JIA). European Respiratory Journal. 2018;52(Suppl. 62):PA2733. Available at: https://elibrary.ru/ynwzsp.
15. Vasilyeva IA, Aksenova VA, Kazakov AV, Kiseleva YY, Maryandyshev AO, Dolzhenko EN et al. Evaluation of the specificity of an intradermal test with recombinant tuberculosis allergen in Bacillus Calmette-Guérinvaccinated healthy volunteers. Front Med. 2023;10:1042461. https://doi.org/10.3389/fmed.2023.
16. Аksenova VА, Gordina АV, Sterlikov SА, Kudlay DА, Kucheryavaya DА, Doktorova NP. Impact of Active Case Finding on Clinical Structure and Severity of Tuberculosis in School-Aged Children (7–15 Years Old). Tuberculosis and Lung Diseases. 2022;100(1):26–32. (In Russ.) https://doi.org/10.21292/2075-1230-2022-100-1-26-32.
17. Poddubnаya LV, Shilovа EP, Kudlаy DA, Doktorovа NP. Immunodiagnostic Tests in the Assessment of Specific Sensitization to M. tuberculosis in Children under the Current Epidemical Situation. Tuberculosis and Lung Diseases. 2021;99(11):47–54. (In Russ.) https://doi.org/10.21292/2075-1230-2021-99-11-47-54.
18. Eremenko EP, Borodulina EA, Sergeeva IA, Kudlay DA, Borodulin BE. Recombinant in vitro test T-SPOT.TB as a screening method for early diagnosis of tuberculosis infection. Tuberculosis and Lung Diseases. 2020;98(4):48–52. (In Russ.) https://doi.org/10.21292/2075-1230-2020-98-4-48-52.
19. Borodulina EA, Kudlay DA, Kuznetsova AN, Gladunova EP, Kalashnikova EV. The use of the ELISPOT technological platform in the diagnosis of tuberculosis infection in patients with HIV infection. Immunologiya. 2021;42(4):395–402. (In Russ.) https://doi.org/10.33029/0206-4952-2021-42-4-395-402.
20. Russkikh OE, Kudlay DA. Place of igra tests (tests for interferon-gamma determination) in tuberculosis infection diagnosis. Pediatriya – Zhurnal im G.N. Speranskogo. 2020;99(6):231–235. (In Russ.) https://doi.org/10.24110/0031-403X-2020-99-6-231-235.
21. Borodulina EA, Kudlay DA, Kuznetsova AN, Gladunova EP, Kalashnikova EV. The use of the ELISPOT technological platform in the diagnosis of tuberculosis infection in patients with HIV infection. Immunologiya. 2021;42(4):395–402. (In Russ.) https://doi.org/10.33029/0206-4952-2021-42-4-395-402.
22. Bаrminа NA, Bаryshnikovа LA. Ways to enhance the efficiency of tuberculosis prevention in the children exposed to tuberculous infection illustrated by the example of Perm Kray. Tuberculosis and Lung Diseases. 2018;96(9):50–56. (In Russ.) https://doi.org/10.21292/2075-1230-2018-96-9-50-56.
23. Bogorodskaya EM, Slogotskaya LV, Belilovsky EM, Roshchupkina OM. Latent tuberculosis infection in the adult risk groups in Moscow city, 2012–2016. Tuberculosis and Socially Significant Diseases. 2017;(2):10–15. (In Russ.) Available at: https://www.tb-journal.ru/jour/article/view/386.
24. Slogotskaya LV, Bogorodskaya EM, Shamuratova LF, Sevostyanova TA. Efficiency of screening for tuberculosis infection in children and adolescents in Moscow in 2019 based on the new procedure for using the intradermal test with tuberculosis recombinant allergen (ESAT-6/CFP-10). Tuberculosis and Lung Diseases. 2021;99(1):15–25. (In Russ.) https://doi.org/10.21292/2075-1230-2021-99-1-15-25.
25. Motanova LN, Konoval OF. Characteristics of the epidemiology and methods of detecting tuberculosis among children under 14 years old in highburden area. Pacific Medical Journal. 2021;(1):85–89. (In Russ.) https://doi.org/10.34215/1609-1175-2021-1-85-89.
26. Аksenova VA, Baryshnikova LA, Klevno NI, Kudlay DA. Screening for tuberculosis infection in children and adolescents in Russia – past, present, future. Tuberculosis and Lung Diseases. 2019;97(9):59–67. (In Russ.) https://doi.org/10.21292/2075-1230-2019-97-9-59-67.
27. Starshinova АА, Dovgalyuk IF, Yablonsky PK, Kudlay DA, Basantsova NYu, Zinchenko YuS. Efficacy of new methods of tuberculosis infection immunodiagnostics in the Russian Federation. Pediatriya – Zhurnal im G.N. Speranskogo. 2019;98(4):229–235. (In Russ.) https://doi.org/10.24110/0031-403X-2019-98-4-229-235.
28. Baronova OD, Odinets VS, Moiseeva NN, Terekhina TV, Аkinina SA. Longterm results of using the skin test with tuberculosis recombinant allergen for tuberculosis detection in Stavropol Region. Tuberculosis and Lung Diseases. 2019;97(5):22–27. (In Russ.) https://doi.org/10.21292/2075-1230-2019-97-5-22-27.
29. Kudlay DA, Starshinova AA, Dovgalyuk IF. Recombinant tuberculosis allergen: 10 years of experience with the test in children and adolescents in the Russian Federation (meta-analysis data). Pediatriya – Zhurnal im G.N. Speranskogo. 2020;99(3):121–129. (In Russ.) Available at: https://pediatriajournal.ru/archive?show=376§ion=5905.
Review
For citations:
Morozova TI, Aleksandrova EN, Salina TY, Kudlay DА, Doktorova NP, Nikolenko NY. Characteristics of tuberculosis infection in children and adolescents (local knowledge). Meditsinskiy sovet = Medical Council. 2025;(9):124-132. (In Russ.) https://doi.org/10.21518/ms2025-182
Views:
132
Email this article 