Modern aspects of specific tuberculosis prevention (analytical literature review)

Abstract

Currently, the only measure for primary specific prevention of tuberculosis is the use of the BCG vaccine. Its protective properties have been demonstrated in generalized tuberculosis in young children, but its effectiveness is low in adults. The BCG vaccine does not protect against latent infection and does not provide lifelong immunity against tuberculosis. The lack of established immune correlates of post-vaccination immunity makes it difficult to determine the duration of immunity and to justify the need for revaccination. In modern conditions, a significant group of unvaccinated children is formed due to parental refusals or medical exemptions. This cohort creates local areas of increased epidemiological risk within the population. Optimizing tuberculosis control in the context of incomplete vaccination coverage becomes a task of precision epidemiology that requires synchronization of preventive, diagnostic, and therapeutic measures. Aim. Сomparative analysis of the effectiveness of BCG/BCG-M vaccination and revaccination in comparison with the dynamics of the epidemic process among non-BCG-M vaccinated individuals in different epidemiological conditions. Materials and methods. Information was searched in MEDLINE/PubMed, Google Scholar, Scopus, and ELIBRARY databases, and manually in the libraries of the Moscow City Scientific and Practical Center for Tuberculosis Control; the Central Research Institute of Tuberculosis; and the State Central Scientific Medical Library. The 4,054 sources were identified, and 79 publications were selected for the review. Results. Тhe analysis revealed inconsistencies and gaps in the data regarding the protective properties of the BCG/BCG-M vaccine. Further in-depth study of the long-term efficacy of vaccination in high-risk adults is required, as is the development of additional preventive measures for unvaccinated individuals.