6. Risk groups for tuberculosis in children and adolescents

The following risk groups are distinguished.

1. According to the results of tuberculin diagnostics: infected children and adolescents. The following signs indicate infection:

1. the presence of positive tuberculin tests in unvaccinated children;
2. the transition of previously negative tests to positive ones;
3. an increase in sensitivity to tuberculin — an increase in the diameter of the infiltrate by 6 mm or more, or an increase in the diameter of the infiltrate less than 6 mm, but the size of the infiltrate is 12 mm or more;
4. the diameter of the infiltrate does not correspond to the size of the post-vaccination scar;
5. the monotonous nature of the samples, without a tendency to fade;
6. hyperergic reactions — an increase in sensitivity to tuberculin in previously infected children.

Children and adolescents should be referred to a TB specialist.

Fluorography is carried out for adolescents from 15 to 17 years old annually, later according to the adult population examination scheme — at least once every 2 years.

2. According to the results of X-ray examinations, groups are distinguished:

1. children and adolescents with newly diagnosed tuberculous changes in the lungs are referred to a phthisiopediatrician;
2. persons with residual post-tuberculous changes detected for the first time are referred to a phthisiopediatrician after establishing an active tuberculous process, observation in I or ΙΙΙ «A» group;
3. persons with residual post-tuberculosis changes — the tactics are consistent with the phthisiatrician.

3. According to the epidemiological danger, cases of contact with people and animals diseased with tuberculosis are singled out, they are sent to a phthisiatrician.

4. According to somatic pathology:

1. frequently and long-term ill children, children with numerous pathologies from various organs and systems are sent to a phthisiatrician to exclude infection and latent tuberculosis infection;
2. for patients with diabetes mellitus — tuberculin diagnostics twice a year, in the presence of a tuberculin infection and post-tuberculosis changes — an X-ray once a year. If symptoms appear from the respiratory organs — a Mantoux test with 2TU, chest radiography, sputum examination for mycobacteria, consultation with a phthisiatrician;
3. patients with peptic ulcer of the stomach and duodenum 12 — tuberculin diagnostics twice a year, in the presence of tuberculosis and post-tuberculosis changes — X-ray once a year, with the appearance of symptoms from the respiratory organs — Mantoux test with 2TU, lung X-ray, sputum on MBT, consultations of a phthisiatrician;
4. persons receiving hormone therapy for a long time, immunosuppressants, after radiation therapy — consultation of a phthisiatrician to agree on the issue of conducting chemoprophylaxis;
5. persons with chronic nonspecific lung diseases — consultation of a phthisiatrician when registering and exacerbating the disease, in case of infection — a picture, sputum analysis for MBT once a year;
6. fractures of large bones, injuries;
7. HIV infection;
8. antisocial families, migrants;
9. not vaccinated (survey — test Mantoux with 2TU, in infected — lung imaging, in the presence of sputum — analysis for mycobacteria).

Note: for those infected in risk groups and with residual post-tuberculosis changes, the issue of preventive chemotherapy should be considered by a phthisiatrician.