Clinical and epidemiological features of tuberculosis in young children in Saint Petersburg

The problem of young children tuberculosis in Russian Federation (RF) still remains actual because of high-level spread of disease between adults and anatomical and physiological features of this period of childhood. The young children morbidity in Saint Petersburg, 2015-2017 became 7.1-5.3 of 100,000 population. It is typical for the age group from 0 to 3 years that tuberculosis development often becomes into the state of active disease and does not stop as latent infection. Our research includes children of early age whose tuberculosis has been diagnosed in 2012-2017 – totally 101 children. One third of the patients were not vaccinated with the BCG vaccine, moreover 41.9% were not vaccinated because of perinatal contact with HIV and 22.5% because of perinatal contact with HIV + hepatitis C. Each second child related to social risk group. Contact with MBT expectorator has been found for 64% of children: drug resistance for at least one drug has been met in 70% cases, including 19% MDR-TB and 11% XDR-TB. Immunology diagnosis analysis showed up that at the moment of the disease detection the tuberculin skin test in 93% cases was positive, but often moderately expressed, meanwhile the Diaskintest was positive in 92% cases, mainly hyperergic or expressed. Objective diagnosis for 79% patients showed symptoms of intoxication of different degrees, for 50% – micropolyadenia, local symptoms – only for 13%. Structure of diagnosis contained mainly intrathoracic lymph nodes tuberculosis (67%), gene ralized forms – 9%, extrapulmonary – 1%. Complicated tuberculosis has been observed in 38% cases. After treatment recovery has been achieved for 98 children, but also 3 lethal cases occurred – all for non-vaccinated infants in case of severe concomitant disease. Conclusion: nowadays development of active tuberculosis in young children is caused by increasing quantity of BCG-unvaccinated newborns – mostly because of perinatal HIV-contact, and poor social conditions.