Effectiveness of tuberculosis detection using a skin test with allergen recombinant (CFP-10-ESAT-6) in children

2015 
Aim: To determine the efficiency of recombinant proteins CFP10-ESAT6 (DST) for screening for tuberculosis (TB) in children and adolescents. Methods: During 2014 inMoscow the Mantoux test with 2 TU PPD-L was performed in 1429395 children and adolescents (97,3% of all children and adolescents), positive reactions were observed in 1058191 individuals (74.0%), among them DST was performed in 88527 (8,4%). All children with positive DST-reactions were performed computer tomography - it was possible to diagnose light forms of TB. Results: Among 88527Mantoux-positive who were examined by the DSTpositive reactions were observed in 3573 cases (4.0%).Among DST-positive new cases of TB were identified in 147 persons (4.1% 95%CI 3.43-4.79),including2 childrenwith HIV infection. Among 88527Mantoux-positive new cases of TB were identified in 0.17%(95%CI 0.14-0.19). Detection rate was 24 times lower compared to positive DST, p=0,000. In 2014 in Moscow number of TB new cases was 166. Among them 151 were examined by the DST and positive DST-reactions were observed in 147 (97.4% 95%CI94.14-100.0%). Negative DST reactions were observed: in2 children who had BCG-ostitis; in 1 child with pleurisyand 1 case of peripheral lymph nodesTB incalcination stage. Among newTB cases, 75.7% were "minor" TB forms. Conclusion: DST demonstrated its high efficiency - detection rate in individuals with positive DST was 24-time higher compared to positive Mantoux test. High sensitivity (97.4%) allows to detect the vast number of TB. Positive DST reaction is the criteria for additional examination using of computed tomography, that allows to detect minor TB forms.
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