Analysis of tuberculosis infection detection in children by mass immunodiagnostic
Abstract
Introduction. Mass immunodiagnostics using a Recombinant Tuberculosis Allergen (RTA) test is aimed at the early and timely detection of Latent Tuberculosis Infection (LTBI) and tuberculosis. Aim. To determine the detection rate of LTBI and tuberculosis in children and adolescents using immunodiagnostics, taking into account the risk of developing tuberculosis infection and the results of screening for its detection. Materials and мethods. A retrospective study of 139 medical records of children aged 1–17 years was conducted between 2023 and 2025 at the Tuberculosis Department of St. Petersburg Children’s Hospital No. 3. Inclusion criteria were positive reactions to the RTA test and/or IGRA test. Exclusion criteria included cases of parental/legal guardian refusal to have the child tested, and infants. A comprehensive screening for tuberculosis infection was conducted, and two groups were identified: Group 1 – 70 children with LTBI, and Group 2 – 69 children with tuberculosis. Results of the RTA test and the Mantoux test were analyzed. Results. During mass immunodiagnostics, tuberculosis infection was detected in 78.4 ± 3.49% (109/139) of patients: 85.7 ± 4.18% (60/70) in children with LTBI, and 71.0 ± 5.46% (49/69) in those with tuberculosis (p = 0.034). This method revealed 13.7 ± 2.92% (19/139) of children from previously unknown tuberculosis contact with tuberculosis patient. The proportion of patients aged 1–7 years with LTBI detected by immunodiagnostics was 72.2 ± 10.56% (13/18), with tuberculosis 45.5 ± 10.62% (10/22) of cases; in children aged 7–18 years it was higher: 90.4 ± 4.09% (47/52) (p = 0.112) and 83.0 ± 5.80% (39/47) of cases (p = 0.0025), respectively. In children aged 1–7 years with tuberculosis, the RTA test was hyperergic more often in 50.0 ± 10.67% (11/22) of cases than with LTBI in 16.7 ± 8.79% (3/18) of cases (p = 0.021); in children aged 8-17 years, the prevalence was 48.9 ± 4.09% (23/47) and 40.4 ± 6.80% (21/52) (p = 0.397), respectively. Conclusion . Mass immunodiagnostics in childhood and adolescence is the most significant method of screening for tuberculosis infection.