[New technologies in the prevention, detection, diagnosis and treatment of tuberculosis in children].

Abstract

If the epidemiological situation is tense, new technologies should be developed and put into practice to enhance the efficiency of specific prevention, early detection, diagnosis and treatment of tuberculosis in children. There is evidence for the high efficacy and low reactogenicity of lower antigenicity-loading BCG-M vaccine that causes a 15-fold decrease in infant morbidity, as compared with that among non-vaccinated children, and this vaccine shows a 5-fold reduction in postvaccination complications as compared with BGC vaccine. The 26-year use of tuberculin diagnosis via Mantoux test with 2TE PPD-L during mass vaccination of children and adolescents has proved itself in early identification of tuberculosis and risk groups. A new risk group has been identified. This includes children with increasing tuberculin reactions; three-month intermittent chemoprevention with isoniazid reduces tuberculin sensitivity in the children and prevents tuberculosis in them. The developed short-term (6-9 months) courses of chemotherapy in preschool and school children by using drugs (isoniazid + rifampicin + pyrazinamide) yield the best healing without residual changes of uncomplicated forms of tuberculosis in 83 and 60% of the children with complicated events, respectively. The chemotherapy regimens have been divided into 4 groups of different dosage schedules.