LIKEHOOD OF DISEASE INCREASES IN THE FOLLOWING SITUATIONS:

1.During the first years after infection.

2.During puberty.

3.When re-infected with MTB (exogenous superinfection).

4.In the presence of HIV infection (up to 8 - 10% per year).

5.In the presence of concomitant diseases (DM, GU and duodenum, pregnancy, alcoholism).

6.During therapy with glucocorticoids and immunosuppressants.

NEWLY DIAGNOSED

PATIENTS DURING REFERENCE

THE FOLLOWING PATIENTS ARE

SUBJECT TO EXAMINATION:

1.With symptoms of inflammatory bronchopulmonary disease:

presence of a prolonged cough (more than 2-3 weeks) with sputum production;

hemoptysis and pulmonary bleeding;chest pain associated with breathing;

2.With intoxication symptoms that persist for more than 2-3 weeks:

increase in body temperature;weakness;

excessive sweating, especially at night;weight loss.

Obligatory minimum diagnostics

(OMD) is performed for all persons with symptoms of respiratory diseases:

1.Clinical examination: complaints studying, anamnesis, physical examination.

2.Laboratory tests: sputum (if any) is examined under a microscope three times for acid-fast mycobacteria using the Ziehl-Nelson stain.

3.X-ray examination of the chest organs in a volume accessible to the institution (the best option: the use of digital fluorography).

For active detection of patients with TB, three study methods are used:

1.Radiation (mainly fluorographic method) - in the adult population and teenagers.

2.Microbiological examination of sputum and urine in persons with symptoms of respiratory and kidney diseases - for adults, teenagers, less often - children.

3.Tuberculin diagnostics - for children and teenagers.

GROUPS OF DISPENSARY OBSERVATION

AND REGISTRATION OF CHILDREN AND

TEENAGERS:

GDO I – patients with active forms of TB of any localization are observed:

•IA – patients with advanced and complicated TB;

•IB – patients with uncomplicated and small forms of

TB.

GDO II – patients with active forms of TB of any localization and chronic course of the disease are observed.

GDO III – patients with a risk of recurrence of TB of any localization:

•IIIA – first detected patients with residual post- tuberculosis changes;

•IIIB – persons transferred from groups I and II, as well as IIIA subgroup.

GROUPS OF DISPENSARY OBSERVATION

AND REGISTRATION OF CHILDREN AND

TEENAGERS :

GDO IV – persons in contact with TB sources:

•IVА – persons from family, relatives and apartment contacts with bacterial excretors, as well as in contacts with bacterial excretors in children's and adolescent institutions; children and adolescents living on the territory of TB facilities;

•IVБ – persons in contact with patients with active TB without bacterial excretion; living in families of livestock breeders who work on TB-affected farms, as well as in families containing farm animals with TB.

GROUPS OF DISPENSARY OBSERVATION

AND REGISTRATION OF CHILDREN AND

TEENAGERS :

V – children and teenagers with complications after anti- tuberculosis vaccinations:

•VA – unites patients with generalized and widespread forms of damage;

•VB – includes patients with local and limited lesions;

•VC – includes persons with inactive local lesions, both newly diagnosed and transferred from subgroups VA and VB.

VI – persons with an increased risk of developing local TB are observed:

•VIA – children and teenagers in the early period of tuberculosis infection (turn of tuberculin reactions);

•VIB – includes early infected children and teenagers with a hyperergic reaction to tuberculin);

•VIC – includes children and teenagers with increasing tuberculin sensitivity.

TUBERCULOSIS

DIAGNOSTIC METHODS

DETECTION OF TB-SPECIFIC CHANGES IN

TISSUES AND ORGANS:Indirect methods:

–anamnesis and physical examination;

–biochemical studies;

–functional studies.

Direct methods – visualization of structural changes:

–in tissues - morphological diagnostics;

–in the organs - radiation diagnostics.

TUBERCULOSIS

DIAGNOSTIC METHODS

DETECTION OF THE TB CAUSATIVE AGENT:Indirect methods:

–tuberculinodiagnosis;

–determination of anti-tuberculosis antibodies;

–study of the release of γ-interferon under the influence of specific MTB agents.

Direct methods:

–bacterioscopic diagnostics;

–bacteriological diagnostics;

–determination of MTB antigens;

–molecular biological methods.

3. TUBERCULINODIAGNOSIS is a set of diagnostic tests to determine the specific sensitization of the body to MTB using tuberculin, an autoclaved infiltrate of MTB cultures.

TUBERCULIN is an incomplete antigen (hapten) that is not able to cause a disease or develop immunity to it, but causes a specific response related to delayed-type allergies, has a high specificity. The occurrence of a specific reaction is possible only under the condition of preliminary sensitization of the MTB organism as a result of spontaneous infection or BCG vaccination.