Immunodiagnosis of tuberculosis infection in children and adolescents from socially vulnerable groups (review and comments)

Tuberculosis as a socially significant disease is the most important medical and social problem of the modern world, including our country. Children and adolescents from socially vulnerable groups require special attention. The high significance of the impact of social factors (standard of living and social protection of families, availability and effectiveness of medical care to the population, the degree of health literacy and cultural competence, migration processes) on the incidence of respiratory tuberculosis in children and adolescents is stressed. Particular attention is paid to the causes of MBT infection and tuberculosis in children and adolescents residing in new Russian regions: high probability of unidentified contact with a tuberculosis patient, often unsanitary living conditions, overcrowding, stress. The level of medical care and anti-tuberculosis measures carried out in these socially vulnerable groups is insufficient due to personal and impersonal reasons. This review is aimed to systematize knowledge about immunodiagnostics of tuberculosis infection in socially vulnerable groups of children and adolescents, to present the principal directive documents and comments on this issue for phthisiologists and paediatricians, taking into account interdisciplinary interaction. We conducted the analysis and systematization of data from current directive, methodological documents, articles, which present the concept of socially vulnerable groups, reflect approaches to the use of skin immunological tests and laboratory diagnostic tests based on the in vitro interferon gamma (IFN-γ) release by T-lymphocytes (IGRA tests) in mass-scale and selective screening in different socially vulnerable groups of children and adolescents. Non-routine situations on the use of immunodiagnostics in socially vulnerable groups are presented.