Legal framework for immunodiagnosis of tuberculosis in pediatric practice

Creation of a legal framework for immunodiagnosis of tuberculosis in paediatric practice in our country began in 1923, when the 2nd All-Russian Tuberculosis Congress and the 2nd All-Union Congress of Paediatricians were held. These congresses were known to approve the medicinal product label for the first tuberculosis diagnostic product Koch's alt-tuberculin. The product continued to improve; hence the method of tuberculin diagnosis has changed overtime. Starting from 2017, medical screening for TB in the paediatric population has been determined in Russia. TB is identified using various tuberculosis allergens according to the age group: a) immunodiagnostic examination of children aged 1–7 years is performed using a bacterial allergen with 2 tuberculin units of purified protein derivative-standard solution; b) immunodiagnostic examination of children aged 8–14 years is performed using the recombinant tuberculosis allergen derivative-standard solution; c) immunodiagnostic examination of children aged 15 through 17 years is performed using recombinant tuberculosis allergen derivative-standard solution or chest X-ray fluoroscopy. This review describes in detail the formation and development of the legal framework for screening for TB in the paediatric population in Russia. Detailed information on the current requirements for immunodiagnosis of TB in children and adolescents in accordance with the current legislation of the Russian Federation is presented. Issues of sanitary legislation, interdisciplinary interaction between primary health care facilities and anti-tuberculosis institutions are highlighted. Answers to the most frequently asked questions on the screening for TB in paediatric practice are provided.