Keywords
Abstract
The aim of the study was to estimate effectiveness of the recombinant tuberculosis allergen (RTA) skin test application for examination of adult contacting persons in the tuberculosis focuses among organized military teams. Materials and methods. We analyzed 2 cases of tuberculosis group incidence among military personnel that have occurred over the past five years. The both sources of tuberculosis infection were patients with destruction of lung tissue and bacterial excretion, who stayed in organized military teams for 6 and 4 months. In total in the infection focuses have been detected 13 and 18 tuberculosis patients accordingly. The number of contacting persons was 100 in the first focus of disease and 951 in the second. Results. In the first case, the reaction to the RTA test in 38 people (38%) was positive, including 30 — hyperergic. An X-ray chest examination revealed no pathology in all 100 contacts. Chest computed tomography (CT) was performed for 30 persons with hyperergic reaction to the RTA test. 9 patients (30%) showed minimal focal changes in the lung tissue, which caused their further examination and treatment in a specialized hospital. After 4 months, at the repeated RTA test of contacts, 5 cases of conversion and 4 cases of increasing severity of the reaction were noted. Chest CT was performed for them, and another patient with focal pulmonary tuberculosis was identified. In the second case, a positive reactions to the RTA test occurred in 214 people (22.5% of the examined contacting persons). The frequency of positive reactions in different units of a large military team (951 people) varied depending on the epidemiological characteristics of the sources of infection. In those units where tuberculosis patients with bacterial excretion were identified, the military personnel had a maximum of positive reactions — 41.2%. Contacting persons in the tuberculosis focuses received a standard course of isoniazid chemoprophylaxis, but those with a positive reaction to the RTA test received a course of preventive treatment of latent tuberculosis infection (LTBI) with two first-line anti-tuberculosis drugs. Repeated cases of disease after 4 years observation in the first and 2 years of observation in the second focus were not detected. Conclusion. Using of the RTA test in the tuberculosis focuses helps to detect persons who need profound examination using high informative method of radiological diagnostics — chest CT. Qualitative carrying out of chemoprophylaxis and preventive treatment of LTBI allows to stop the further spread of the disease among organized military teams.