tibljТуберкулез и болезни легкихTuberculosis and Lung Diseases2075-12302542-1506Медицинские знания и технологии10.21292/2075-1230-2022-100-11-29-38tiblj-1690Research ArticleОРИГИНАЛЬНЫЕ СТАТЬИORIGINAL ARTICLESCкрининг туберкулезной инфекции у детей и подростков на основе применения двух внутрикожных тестов: с туберкулином и аллергеном туберкулезным рекомбинантным (ESAT-6/CFP-10) в Москве в 2021 г.Screening for tuberculosis infection in children and adolescents by two intracutaneous tests: with tuberculin and tuberculosis recombinant allergen (ESAT-6/CFP-10) in Moscow in 2021https://orcid.org/0000-0003-4552-5022БогородскаяЕ. М.BogorodskayaE. M.

Богородская Елена Михайловна, доктор медицинских наук, профессор, директор

107014, Москва, ул. Стромынка, д. 10

Elena M. Bogorodskaya, Doctor of Medical Sciences, Professor, Director

10, Stromynka St., Moscow, 107014

el_bogorodskaya@mail.ruhttps://orcid.org/0000-0001-9956-2385СлогоцкаяЛ. В.SlogotskayaL. V.

Слогоцкая Людмила Владимировна, доктор медицинских наук, заведующая научно-клиническим отделом

107014, Москва, ул. Стромынка, д. 10

Ludmila V. Slogotskaya, Doctor of Medical Sciences, Head of research Clinical Department

10, Stromynka St., Moscow, 107014

lyu186@yandex.ruhttps://orcid.org/0000-0002-4808-0658ШамуратоваЛ. Ф.ShamuratovaL. F.

Шамуратова Луиза Фазыловна, заведующая отделением фтизиопедиатрической помощи организационно-методического отдела

107014, Москва, ул. Стромынка, д. 10

Luiza F. Shamuratova, Head of Pediatric Phthisiologic Care Unit of Statistic and Reporting Department

10, Stromynka St., Moscow, 107014

l.shamuratova@yandex.ruhttps://orcid.org/0000-0003-1499-4934СевостьяноваТ. А.SevostyanovaT. A.

Севостьянова Татьяна Александровна, заведующая детским консультационно-диагностическим отделением, доцент кафедры фтизиатрии ЛФ

107014, Москва, ул. Стромынка, д. 10

117997, Москва, ул. Островитянова, д. 1, стр. 7

Tatiana A. Sevostyanova, Head of Pediatric Consulting and Diagnostics Department, Associate Professor, Phthisiology Department, General Medicine Faculty

10, Stromynka St., Moscow, 107014

1, Bd. 7, Ostrovityanova St., Moscow, 117997

sewata@yandex.ruГБУЗ «Московский городской научно-практический центр борьбы с туберкулезом Департамента здравоохранения города Москвы»; ФГБОУ ДПО «Российская медицинская академия непрерывного профессионального образования» МЗ РФРоссияMoscow Municipal Scientific Practical Center of Tuberculosis Control; Russian Medical Academy of On-going Professional EducationRussian FederationГБУЗ «Московский городской научно-практический центр борьбы с туберкулезом Департамента здравоохранения города Москвы»; ФГБОУ ДПО «Российская медицинская академия непрерывного профессионального образования» МЗ РФРоссияMoscow Municipal Scientific Practical Center of Tuberculosis Control, ; Russian Medical Academy of On-going Professional EducationRussian FederationГБУЗ «Московский городской научно-практический центр борьбы с туберкулезом Департамента здравоохранения города Москвы»РоссияMoscow Municipal Scientific Practical Center of Tuberculosis ControlRussian FederationГБУЗ «Московский городской научно-практический центр борьбы с туберкулезом Департамента здравоохранения города Москвы»; ФГАОУ ВО «Российский национальный исследовательский медицинский университет им. Н. И. Пирогова» МЗ РФРоссияMoscow Municipal Scientific Practical Center of Tuberculosis Control; Pirogov Russian National Research Medical UniversityRussian Federation202209122022100112938Copyright © Богородская Е.М., Слогоцкая Л.В., Шамуратова Л.Ф., Севостьянова Т.А., 20222022Богородская Е.М., Слогоцкая Л.В., Шамуратова Л.Ф., Севостьянова Т.А.Bogorodskaya E.M., Slogotskaya L.V., Shamuratova L.F., Sevostyanova T.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.tibl-journal.com/jour/article/view/1690Цель

Цель: оценка эффективности массового cкрининга на туберкулезную инфекцию у детей и подростков в г. Москве с использованием двух разных вариантов в соответствии с возрастом; определение влияния пандемии COVID-19 на эффективность кампании по показателям заболеваемости детей и подростков.

Материалы и методы

Материалы и методы. В 2021 г. с помощью пробы Манту было обследовано 758 634 ребенка в возрасте 0-7 лет, или 99,2%подлежащих обследованию. При нарастании реакции по сравнению с предыдущим годом выполнялась дополнительно проба с аллергеном туберкулезным рекомбинантным (АТР). Детям 8-17 лет скрининг проводился только с помощью пробы с АТР. Был обследован 1 070 961 человек, или 97,9% от подлежащих обследованию.

Результаты

Результаты. Показано, что проба с АТР при скрининге позволяет эффективно выявлять пациентов с высоким риском развития туберкулеза. Проведение превентивной терапии лицам с положительной реакцией на пробу с АТР привело практически к отсутствию заболевания у них. Преобладание среди впервые выявленных лиц с посттуберкулезными изменениями над впервые выявленными случаями туберкулеза при снижении численности тех и других указывают на способность методов (АТР вместе с компьютерной томографией) выявлять малые формы активного заболевания и посттуберкулезные изменения. В 2021 г. в сравнении с 2020 г. число детей, выявленных с туберкулезом, статистически незначимо увеличилось за счет тех, кто не был выявлен в 2020 г. в связи с неполным охватом обследованием, связанным с распространением COVID-19. Показатели в 2021 г. тем не менее были ниже, чем в 2019 г., что подтверждает их положительную динамику.

Вывод

Вывод. Скрининг с применением пробы с АТР эффективен, прост в выполнении и может использоваться в первичном звене здравоохранения.

The objective

The objective: to evaluate effectiveness of mass screening for tuberculosis infection in children and adolescents in Moscow using two different options according to age; to determine impact of the COVID-19 pandemic on effectiveness of screening campaign judging by incidence rates in children and adolescents.

Subjects and Methods

Subjects and Methods. In 2021, 758,634 children aged 0-7 years, or 99.2% of those to be screened, were screened using the Mantoux test. Should the reaction increase compared to the previous year, an additional test with the tuberculosis recombinant allergen (TRA) was performed. Children of 8-17 years old were screened only with TRA test. 1,070,961 people were examined, or 97.9% of those to be examined.

Results

Results. It has been demonstrated that the test with TRA can be used as a screening tool and effectively identify patients with a high risk of tuberculosis development. The preventive therapy received by those positively responding to TRA test resulted in almost no disease in them. The predominance of new cases with post-tuberculosis changes over new cases of active tuberculosis while the number of both is decreasing indicates the ability of the methods (TRA together with computed tomography) to detect minor forms of the active disease and post-tuberculous changes. In 2021 versus 2020, the number of children diagnosed with tuberculosis did not statistically significantly increase because of those who failed to be detected in 2020 due to incomplete coverage with screening related to spread of COVID-19. However, in 2021 the rates were lower than in 2019 which confirmed their positive change.

Conclusion

Conclusion: Screening with TRA test is effective, easy to perform and can be used in primary health care.

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The authors declare that there are no conflicts of interest present.