Clinical and epidemiological significance of сonversion of the skin test with recombinant tuberculosis allergen in children

Since 2015, an intradermal test with recombinant tuberculosis allergen (RTA) has been used in the Russian Federation for the purpose of screening for tuberculosis infection in children from the age of 8 and examination for tuberculosis in children of all ages. In order to establish the clinical and epidemiological significance of the conversion of the RTA test from negative to positive, 80 children with the presence of conversion of this test within 1 year were studied. The data on tuberculosis contacts, the dynamics of the Mantoux test 2 TU, the results of the examination, including multispiral computed tomography, were studied. As a result of the study, the children have been divided into 3 groups: group 1 — 30 (37.5%) children with latent tuberculosis infection, group 2 — 25 (31.3%) children with newly diagnosed residual post-tuberculous changes, group 3 — 25 (31.3%) patients with active tuberculosis. Most children of the 3rd group had contact with a tuberculosis patient, that was 22 (88.0%) patients; among them, there were 18 (72.0%) patients from bacillary contacts, which is significantly more than in children of groups 1 and 2. The coincidence of the conversion of the RTA test with the conversion of the Mantoux test 2 TU was observed in 33.7% of cases. These children had the greatest risk of the disease, most of them, 23/27 (85.2%), had the conversion of both tests in the presence of bacillary tuberculosis contact. In the case of contact with a tuberculosis patient in 80.4% of children, the conversion of the RTA test occurred during the first year. It is concluded that the conversion of the RTA test is a significant indicator of the activation of tuberculosis infection in the body.

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