Clinical manifestations and outcomes of tuberculosis in children in the Irkutsk region

100 children were observed. Tuberculosis of inrathoracic lymph nodes was found in 79 (79,0 %) patients, complicated tuberculosis - in 29 (36,7 %) of 79 patients. The phase of reverse development of tuberculosis was detected in 47,0 % of children with TB. Due to the slow dynamics of the disease, the duration of chemotherapy in 75,0 % of children was 240 days. In the mode of treatment, drug resistance of a patient in lesion of tuberculosis infection is taken into account. As a result of treatment, resorption of infiltration in the lungs was observed in 15,0 %, fibrosis - in 26,0 %, formation of small calcifications - in 39,0 %, formation of multiple large calcifications - in 20,0 % of children. The cause of the formation of calcifications is the late detection of tuberculosis. In children with the formation of calcifications throughout the course of treatment the number of leukocytes decreased, the downward trend in the absolute number of lymphocytes to the 4th month of treatment was traced, the content of leukocytes increased to the end of primary treatment. In children without formation of calcifications the reduction of leukocytes and lymphocytes was not identified during the treatment. The decrease in the content of leukocytes and lymphocytes may explain long-term persistence of endogenous intoxication

Medical and social characteristics of children with tuberculosis in conditions of social insufficiency in the Irkutsk region

Background. In cases of tuberculosis in children, contacts with patients with drug-resistant forms are often detected. Treatment and prevention of the disease is based on these data and adherence to treatment. Aims. To analyze the social status of the family of children with tuberculosis, clinical forms and drug resistance of MBT in patients who are sources of infection in the outbreak for adequate planning of preventive treatment of contact and treatment of children with tuberculosis. Materials and methods. The study involved 150 children with tuberculosis treated in a hospital in 2009-2012 and 142 children - in 2015-2017. We studied social factors and drug resistance of Mycobacterium tuberculosis in adult patients - sources to child transmission. Drug resistance of MBT cultures was determined by Löwenstein - Jensen medium and automated system BACTEC MGIT 960. Results. 50.0 % of children with tuberculosis are patients of preschool age, 33.0 % of children aged under 3 years. From 2009-2012 to 2015-2017 the proportion of socially disadvantaged families fell from 68.0 % to 45.1 %. At the same time the proportion of children with tuberculosis, contracted from a known contact decreased from 70.0 % to 57.0 %. Often children get infected from mother or from several close relatives (mother, father, grandfather, grandmother), TB patients source of infection of children are often diagnosed with infiltrative (21.9-38.3 %) and fibro-cavernous tuberculosis (17.0-21.0 %). To 2015-2017 multi-drug resistance in the nidi was recorded at 52.2 %. The development of tuberculosis in children was facilitated by the defects of preventative measures: absence of BCG vaccination (from 9.0 to 14.0 % of children), the absence of preventive treatment (55.3-67.5 %)

CHARACTERISTIC OF MULTIDRAG RESISTANCE IN TUBERKULOSIS PATIENTS IN SEPARATE TERRITORIES OF IRKUTSK REGION

The prevalence of multi-drug resistance (MDR) in separate territories of the Irkutsk region is different, which is associated with the geographical features and the availability of microbiological research facilities. Between 2003 and 2015, the proportion of new TB cases with MDR increased in most of the territories of the region except "Large Cities" and the Buryat national district. In Large Cities of Irkutsk region and Buryat district MDR level is high, but the growth rate is insignificant. The area of "Major settlements along the railway" was characterized by an intensive increase in the proportion of first-time detected and previously treated TB patients with MDR. One reason for this phenomenon is the intense migration of the population. In "Northern areas" there was an accumulation of MDR among contingents associated with the empirical assignment of anti-TB drugs and low availability of microbiological testing. In the "Rural areas" MDR was rarely identified due to troubles with microbiological diagnostics