Contact of adolescents with a TB patient: acute issues according to the specialist hospital

Introduction. Any contact with a TB patient is the leading risk factor for developing TB disease in children and adolescents, and availability of a family/close relative contact matters the most for its realization. TB foci with multidrug-resistant and extensively drug-resistant Mycobacterium tuberculosis (MDR/XDR MBT) strains that are present at the source of infection require special attention as the most epidemically dangerous ones.

Aim. To identify the major reasons for the development and late diagnosis of TB disease in adolescents from the infection foci, and to find possible ways to address identified issues.

Materials and methods. A retrospective cohort study (2021 to 2023) was conducted. 90 medical records of adolescents were analysed. In 53 cases, contacts with a TB patient were identified (58.9%). The statistical relationship between the studied risk factors that could affect the late detection of the TB disease was calculated using the Pearson χ2 test.

Results. It has been established that a lack of proper follow-up medical care over exposed persons at the tuberculosis dispensary (TBD) (violations of the procedures for follow-up checkups, preventive chemotherapy) and missed opportunities in mass screening in the primary health care (PHC) facilities are the main reasons for late detection of the disease, especially when several risk factors are combined, and clinical signs of the disease are present. TB screening methods applied at the infection foci have proven to be most effective when implemented on a regular basis. The disease can manifest during long intervals between medical checkups in the absence of pronounced clinical symptoms of the disease and in a torpid course, which identifies inconsistency between TB diagnostic techniques (screening) and its clinical form (widespread, complicated processes).

Conclusion. To solve this issue, the following measures are required: mandatory follow-ups of exposed persons at the TBD regardless of legal representative / patient’s wishes; determination of the conditions for isolation of a source of infection from a contact adolescent until bacterial excretion is completed; personalized follow-up care and thorough medical checkups of exposed persons, if MDR/XDR MBT strains are identified at the source of infection; improvement of interdisciplinary collaboration between primary health care facilities.

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