[Effectiveness of new diagnostic drug Diaskintest in children for tuberculosis diagnostic].

DST was ascertained to have a high sensitivity in virtually all patients with tuberculosis and a positive reaction was first noted in the infected. With stabilization and regression, the response to DST was much less pronounced than that in clinical and primary infection (that to the Mantoux test being more evident). DST showed its use as a marker of active tuberculosis not only in its local forms, but also in latent tuberculous infection. This makes it possible to apply DST when preventive treatment is performed. The agent may be used to monitor the progress of treatment. DST has a high specificity--healthy individuals had a negative response to DST while the Mantoux test was positive in many cases. The high specificity of DST was suggested by the fact that the persons vaccinated with (this caused BCG ostitis) had a negative reaction to DST while the Mantoux test was positive in all cases BCG-vaccinated BCG. The findings warrant the use of DST for the differential diagnosis of tuberculosis and BCG-associated complications and the possibility of differentiating postvaccinal and infection allergy in children and adolescents.

[Clinical trials of the new skin test Diaskintest for the diagnosis of tuberculosis].

A new reagent for a skin test given the name Diaskintest has been designed for the screening diagnosis of tuberculosis and preclinical and clinical trials conducted. Preclinical trials were carried out on 315 laboratory animals (guinea-pigs, albino mice). The reagent Diaskintest was ascertained to be nontoxic, to have no sensitizing properties, to be safe and specific, and to induce no positive reactions in BCG-vaccinated animals and healthy guinea-pigs. Its specific activity was comparable with that of the national reference--purified tuberculin PPD-L-2. With progression of tuberculous lesions, the guinea-pigs showed higher responses to Diaskintest dilution and the BCG-vaccinated animals lacked responses to Diaskintest with increased delayed type hypersensitivity. The clinical trial was permitted by the Federal Service for Surveillance in Health Care and Social Development of the Russian Federation. Clinical trials were conducted in 150 persons. The safety, specificity, sensitivity of Diaskintest were first examined in the clinical studies and its action was compared with the results of tuberculin skin test (Mantoux test) with 2 TE of PPD L-2. Diaskintest was ascertained to be highly sensitive when given in a dose of 0.2 microg in 0.1 ml. In patients with active tuberculosis and new cases of Mycobacterium tuberculosis infection, the agent induced a positive skin reaction (a papule of more than 10 mm) in 98-100% of cases (p < 0.05). The agent caused no reaction associated with BCG vaccination. The specificity of the test was 93-100% with 95% significance. The rate of overexuberant reactions (vesicular necrotic changes, lymphangitis, and lymphadenitis) was 4-14% with 95% significance. Tuberculosis patients with significant immunopathological disorders might have no skin sensitivity to Diaskintest, as to PPD L-2 (a negative test). The findings substantiate the use of Diaskintest for mass epidemiological surveys for the differential diagnosis of tuberculosis and BCG vaccination-associated complications. The agent may be also used to evaluate the activity of the process in patients with tuberculosis and the efficiency of treatment in combination with other methods and to make a differential diagnosis of tuberculosis.

[Influence of social factors on tuberculosis mortality, effectiveness of sociomedical preventive measures in Moscow in the 20th century]. / Vliianie sotsial'nykh faktorov na smertnost' ot tuberkuleza, éffektivnost' mer mediko-sotsial'noi zashchity v Moskve v 20m stoletii.

The correlations between the time series of weather values of sociodemographic, socioeconomic, and epidemiological parameters of tuberculosis (death rates) in the 20th century were studied. Analysis of population indices confirmed the association of migratory processes and the intensity of the tuberculosis epidemic situation, as well as the significance of these processes for Moscow, the necessity of their notification for assessing the sociodemographic situation to plan tuberculosis-controlling measures. The study has indicated that there is a relationship of the salary/wage that determines the income of the bulk of the population to tuberculosis mortality rates and that regulation of a migratory process, population density, and improvement of living conditions are of considerable importance in the prevention of this disease. Comparative analysis of the data in the periods when the whole contemporary rather effective complex of tuberculosis-controlling measures (1953-2000) and when the above complex were only formed (1910-1953) has demonstrated the economic efficiency of the above measures. It is stated that the system of sociomedical protective measures is a real factor that may rather effectively withstand the poor social conditions promoting the spread of tuberculosis.

[Automated methods of culture determination of M. tuberculosis in liquid media]. / Avtomatizirovannye metody kul'tural'nogo opredeleniia M. tuberculosis na zhidkikh sredakh,

A hundred and seventy respiratory samples from patients with different forms of tuberculosis were used to test the efficiency of the automatic liquid culture systems BACTEC MGIT 960 and MB/BacT with inoculation into the standard dense media. All these media provided 47 M. tuberculous isolates, of them 41 (87.2%), 38 (80.9%), and 76.6% on the BACTER 960, MB/BacT, and dense media, respectively. The average time of detection of mycobacterial growth by means of automatic systems was much shorter and equal to 10.7 days on the BACTEC 960 and 18.7 days on the MB/BacT versus 33.2 days on the standard dense medium. In terms of their sensitivity and detection rate, the automatic systems were superior to the dense media widely used in laboratory practice.

[Significance of hereditary predisposition factors in the development and course of pulmonary tuberculosis]. / Znachenie faktorov nasledstvennoi predraspolozhennosti v razvitii i techenii legochnogo tuberkuleza.

Comprehensive clinical, genetic, epidemiological, and immunogenetic studies have established that tuberculosis is a multifactorial disease whose development and natural history are due to the interaction of environmental factors, primarily, to infection and hereditary predisposition. Associations between tuberculosis and various HLA loci B antigens, as well as HLA locus D-DR2 antigen have been detected in different populations. The HLA genotype was shown to differ in patients with favourable and unfavourable tuberculosis natural history. The comprehensive study of genetic markers allows one to make a prompt assessment of the nature of a tuberculous process, to define its prognosis and to correct treatment.