PT  - JOURNAL ARTICLE
AU  - Ludmila Slogotskaya
AU  - Elena Ovsyankina
AU  - Vitaliy Litvinov
AU  - Yakov Kochetkov
AU  - Petr Seltsovsky
AU  - O. Senchikhina
AU  - L. Stakheeva
AU  - Dmitriy Koudlay
TI  - Tuberculosis detection in children and adolescents using diagnostic testing based on tuberculosis recombinant protein E SAT6-CFP10 (diaskintest)
DP  - 2011 Sep 01
TA  - European Respiratory Journal
PG  - p4983
VI  - 38
IP  - Suppl 55
4099  - http://erj.ersjournals.com/content/38/Suppl_55/p4983.short
4100  - http://erj.ersjournals.com/content/38/Suppl_55/p4983.full
SO  - Eur Respir J2011 Sep 01; 38
AB  - Background: Until recently, the tuberculin skin test (TST) has been the only diagnostic method for latent tuberculosis infection (LTBI). However, the specificity of TST is low, because the purified protein derivative (PPD) used for TST contains numerous M. tuberculosis (MTB) antigens that are almost identical to BCG antigens or similar to non-TB mycobacterium (NTM) antigens. Of those 99% BCG vaccinated in Russia it is very difficult to diagnose LTBI. DIASKINTEST (DST) consists of two MTB-specific antigens - ESAT-6 and CFP-10, which are absent in all M. bovis BCG substrains and in most of NTM antigens. Aim was to evaluate to evaluate the role of DST in TB detection.Method: 1675 children and adolescents with conversed tuberculin reaction, reaction size increased by more than 6 mm, hyperergy, TB contacts (social and household) received the Mantoux test with 2 TU PPD-L and DST 0.2 mkg/0.1 ml.Result: 95,8% -TST-positive. 349 (20,8%) - DST- positive, all - chest X-rayed plus computer tomography (CT). TB was diagnosed in 148 (42,4%). Out of them 6 were initially DST negative but after 3 months DST was repeated and resulted positive- active TB was diagnosed. In 19 (5,5%) TB was in the calcination phase. 9 TB contacts with established TB were DST-negative. All had BCG vaccination. 4 children one year old, probably, had not developed immunity. Two had contacts with TB/HIV parents.Conclusion: DST allows detecting TB in 42,4% of cases. DST negative reaction could be in early aged TB patients – when immune response has not been developed yet. DST positive reaction may develop later in vaccinated children.