Practical issues in detecting and diagnosing TB infection in children and assessment of the degree of risk for developing TB

This article reviewed and systematized data from full-text publications on the development of TB infection in humans found in search engines scholar.google.ru, researchgate.net, MEDLINE, and the scientific electronic library eLIBRARY.RU. A 50-year literature search was conducted using the following keywords: Mycobacterium tuberculosis exposure, latent tuberculosis infection, latent microbiism, tuberculin sensitivity conversion, tuberculosis infection, diagnosis, children. 50 articles published by leading international and Russian specialists in phthisiology and pediatrics were reviewed. Data on current understanding of tuberculosis infection, 7P pediatrics, details of the subject of clinical diagnosis, and conversion of descriptions defining the state of infection with Mycobacterium tuberculosis were obtained. Due to absence of precise criteria/biomarkers for incipient tuberculosis, it is necessary to assess a risk for developing tuberculosis in children by specifying it in the clinical diagnosis description. It has been established that modern immunological skin tests (recombinant tuberculosis allergen test (Diaskintest, Russia) and laboratory (TigraTest®TV (Russia)) tests assessing release of interferon gamma by T-lymphocytes (IGRA-tests) in response to exposure to the specific antigen proteins ESAT6 and CFP10 are important criteria for increased risk for developing tuberculosis. To decide on the initiation of prophylactic anti-tuberculosis treatment, it is required to assess the degree of risk for developing TB. The authors proposed a system for assessing the degree of risk for developing TB in children based on risk factors and the results of IGRA-tests. Adding the degree of TB risk to the clinical diagnosis description in TB infection will ensure targeted interventions for target pediatric groups in accordance with the principles of a new trend in clinical and fundamental medicine – developmental pediatrics and health programming.