Efficacy of Tuberculosis Preventive Treatment, Including Video-Observed Therapy, in Children with Latent Tuberculosis Infection and Without Risk of Multidrug Resistance

The objective: to assess the efficacy of tuberculosis preventive treatment (TPT) in children with latent tuberculosis infection (LTBI) and without risk of multidrug-resistant tuberculosis (MDR-TB), and to identify the advantages of video-observed therapy.

Materials and Methods. A cohort of 572 children aged 0 to 17 years (inclusive) with LTBI and positive recombinant tuberculosis allergen (RTA) tests was analyzed. Children with exposure to multi-drug resistant tuberculosis (MDR-TB) were excluded from the study. TPT was administered to 480 (83.9%) children: Group I (no known TB exposure) – n=295, Group II (known TB exposure) – n=163, Group III (video-observed TPT) – n=22 children (no known TB exposure). Parents of 92 (16.1%) children (Group IV) refused TPT. Video-observed therapy was conducted via the Yandex Telemost platform. Statistical analysis was performed using the SPSS 17.0 software package.

Results. Within two years after TPT, 13.04% of children in Group IV developed TB compared with 0.34% in Group I and 1.8% in Group II, no cases were observed in Group III. No adverse reactions (ARs) were reported in children receiving video-observed therapy (Group III), whereas in Groups I and II ARs were reported in 20.0% and 39.9% of children, respectively (p<0.05). Reported ARs were mild. A reduction in local response to the recombinant tuberculosis allergen test (Diaskintest) was observed among children who received TB preventive treatment: 87.5% in Group I, 79.1% in group II, and 86.4% in group III, compared with only 26.1% in those who did not receive TB preventive treatment (Group IV) (p < 0.05). Conclusions were drawn regarding the efficacy and safety of video-observed TPT.

1. Baronova O.D., Aksenova V.A., Luginova E.F., Dolzhenko E.N. The use of rifapentine for preventive chemotherapy in children from risk groups of developing tuberculosis. Tuberculosis and Lung Diseases, 2022, Vol. 100, No. 8, pp. 31–36 (In Russ.). http://doi.org/10.21292/2075-1230-2022-100-8-31-36.

2. Vladimirskiy M.A., Lapenkova M.B., Elov A.A., Aksenova V.A., Plekhanova M.A., Smerdin S.V., Rutkevich P.N. Immunobiological Methods for Monitoring Latent Tuberculosis Infection in Children and Adolescents and Analysis of Tuberculosis Infection Reactivation. Tuberculosis and Lung Diseases. 2024;102(6):32-38 (In Russ.). https://doi.org/10.58838/2075-1230-2024-102-6-32-38.

3. Glushakov IA, Lozovskaya ME, Gutkin MG, Vasilyeva EB, Tomilova IA, Korf GV. Latent tuberculosis infection in children and adolescents: preventive treatment issues. Children’s Medicine of the North-West. 2024;12(2):187– 194 (In Russ.) https://doi.org/10.56871/CmN-W.2024.88.83.018.

4. Clinical guidelines; latent tuberculosis infection in children. All-Russian public organization “Russian Society of Phthisiologists”, 2024 (In Russ.) URL: http://roftb.ru/structure/. Accessed December 12, 2025.

5. Ovsyankina E.S., Panova L.V., Khiteva A.Yu., Viechelli E.A. Reasons for late diagnostics of tuberculosis in adolescents. Rossiyskiy Vestnik Perinatologii i Pediatrii. 2019;64(1):76-80. (In Russ.). https://doi.org/10.21508/1027-4065-2019-64-1-76-80.

6. Pavlyuchenkova N.A., Vasilyeva I.A., Samoylova A.G., Tyulkova T.E. Video Observed Treatment is an Innovative Method of Tuberculosis Treatment Observation in Resource-Limited Health Care Settings. Tuberculosis and Lung Diseases. 2022;100(2):53-60. (In Russ.). https://doi.org/10.21292/2075-1230-2022-100-2-53-60.

7. Pakhlaonova A.D., Kazakov A.V., Aksenova V.A., Klevno N.I., Popov S.A., Khotchenkov V.P., Ruzhitsky A.O., Sabgayda T.P. Pharmacokinetics of FDC: rifampin and isoniazid in children with respiratory tuberculosis. // Modern problems of science and education. – 2020;(6). (In Russ.) URL: https://science-education.ru/ru/article/view?id=30258. Accessed January 25, 2026.

8. Slogotskaya L.V., Lovacheva O.V., Klevno N.I. Stages of Tuberculosis Infection, What's New? (Literature Review). Tuberculosis and Lung Diseases. 2025;103(2):93-101. (In Russ.). https://doi.org/10.58838/2075-1230-2025-103-2-93-101.

9. Order of the Chief Physician of the Petrograd-Primorsky Interdistrict TB Dispensary No. 3 No. 2-r dated December 17, 2024 “On the procedure for providing observed treatment on an outpatient basis.” 2024. (In Russ.) URL: http://zdrav.spb.ru/. Accessed January 20, 2026.

10. Implementing the End TB strategy: the essentials. World Health Organization, 2018. URL: https://iris.who.int/handle/10665/311316 [Accessed 25 January, 2026].

11. Stavitskaya N.V. Research of genetic factors in children with latent TB infection // Fundamental research. – 2010;(5):53-59. (In Russ.)

12. Usacheva N.E., Myakisheva T.V., Novikov V.E. Immunodiagnostics of tuberculosis infection in children // Vestnik of Smolensk State Medical Academy. –2021;20(1):101-106. (In Russ). https://doi.org/10.37903/ vsgma.2021.1.15

13. Khodorenko VA, Yarovaya YuA, Lozovskaya ME, Мaksemenyuk EV, Zubkova EV. Assessment of parents’ commitment to specific treatment of children with tuberculosis. Children’s medicine of the North-West – 2023;11(3):125-130. (In Russ.) https://doi.org/10.56871/CmN-W.2023.11.42.010.

14. Baryakova T.H., Pogostin B.H., Langer R., McHugh K.J. Overcoming barriers to patient adherence: the case for developing innovative drug delivery systems // NatRevDrugDiscov. – 2023. – Vol. 22, № 5. – Р. 387-409. https://doi.org/10.1038/s41573-023-00670-0.

15. Global tuberculosis report 2024. Geneva: World Health Organization, 2024. Available at: https://www.who.int/teams/globaltuberculosis-programme/tb-reports/global-tuberculosis-report-2024. Accessed January 09, 2025.