[Antituberculosis care of children and adolescents in tuberculosis risk groups]. / Protivotuberkuleznaia pomoshch' detiam i podrostkam iz grupp riska po tuberkulezu.

Because of deterioration of epidemiological situation by tuberculosis, individuals from tuberculous infection foci and social risk group require special care. It is important to integrate efforts of phthisiatric and general therapeutic and prophylactic services in detection of tuberculosis in children and adolescents, to create controlled conditions for conduction of antituberculous measures.

[Detection of tuberculosis in children of new risk groups and efficacy of chemoprophylaxis]. / Vyiavlenie tuberkuleza u detei iz novykh grupp riska i effektivnost' khimioprofilaktiki.

109 children at risk of tuberculosis frequently suffering from acute respiratory diseases (ARD) and 87 children with rare ARD have undergone a 3-month course of isoniazide chemoprophylaxis. In 95.0% of the examinees the above chemoprophylaxis lowered ARD morbidity to 1-2 times a year, reduced and stabilized tuberculin sensitivity, prevented tuberculosis. Isoniazide treatment of 87 children whose parents worked with cattle that might be infected prevented tuberculosis in them, diminished tuberculin sensitivity. It is thought valid that chemoprophylaxis should be given in sanatoria primarily to children exposed to two and more risk factors (epidemiological, age-sex, medicobiological, social).

[Tuberculosis in children and adolescents as a social problem]. / Tuberkulez u detei i podrostkov kak sotsial'naia problema.

Under the conditions of society's socioeconomic instability and increased migratory processes, ever increasing numbers of children and adolescents are being brought up in socially disadapted families. The social status of a family largely determines the infection and morbidity rates of tuberculosis and affects the diagnosis, course and prognosis of the disease in children and adolescents. The infection rates in this group of children are 2-5 times higher than those of children in Russia, the risk of primary infection is 10.9%. In children and adolescents from the socially disadapted families, there was a torpid and undulating course in 50% of cases, 25% being found to have primary resistance to antituberculous drugs, which corresponds to that in the source of infection. To enhance the efficiency of antituberculous diagnostic and therapeutic measures among children and adolescents from socially disadapted population groups, the Ministry of Internal Affairs, public educational institutions, and the general therapeutical network should jointly make a complex of measures within the framework of a goal-oriented sponsored programme.

[Tuberculosis risk groups among children and principles of approach to chemoprophylaxis]. / Gruppy riska zabolevaniia tuberkulezom u detei i printsipy podkhoda k naznacheniiu khimioprofilaktiki.

The trends in tuberculin reactions of Mantoux test (2 TU) performed annually before and after the diagnosis of tuberculosis shows that the risk groups consist of subjects with increasing tuberculin sensitivity and those susceptible to acute respiratory virus infections. An individual approach to prescription of chemoprophylaxis considering the number of risk factors (epidemiological, age-sex, biomedical, social) is advisable. Sanatorium chemoprophylaxis is needed in the presence of at least 2 factors. A 3-month isoniazid chemoprophylaxis prevents the disease and normalizes sensitivity to tuberculin.

[Tuberculosis in children and adolescents in orphanage and boarding schools and optimization of its prevention]. / Tuberkulëznaia infektsiia u detei i podrostkov detskikh domov i shkol-internatov i optimizatsiia profilakticheskikh meropriiatii sredi nikh.

Clinical examinations and follow-up were conducted in 1641 children and adolescents at risk of tuberculosis infection. Of them, 701 examinees attended children's homes and boarding schools, 940 controls went to kindergartens and secondary schools. The trial revealed that the test group children and adolescents are at much higher risk to develop tuberculosis than controls. Primary infection and the disease were recorded in them 8.5 and 1.8 times more frequently, respectively. These facts urge compulsory introduction in children's homes and boarding schools as the foci of minor bacterial dissemination of the whole complex of antituberculosis measures, tuberculin diagnosis twice a year and isoniazid chemoprophylaxis, particularly.

[Questionnaire for detecting the risk of tuberculosis infection in children and adolescents in boarding schools]. / Anketirovanie v vyiavlenii faktorov riska tuberkuleznoi infektsii u detei i podrostkov shkol-internatov.

The results of questionnaires given to students of boarding schools who live in the areas differing in epidemiological situation are presented. In compiling questionnaires consideration should be given to the social composition of students and the epidemiological situation in the area. Questionnaires collected in the areas with a favorable situation enable one to form more fully new groups of risk (IVB, VIB) for tuberculosis, to improve health education aimed at raising social culture (harm of smoking, alcohol abuse and their association with tuberculosis, etc.). In the unfavourable epidemiological areas they play the leading role in the adequate formation of Dispensary Registration Group IV duet to the deeper search for a source of infection. Hence, health education should be mainly concerned with the development of hygienic habits in students.

[Ways of prevention and early detection of tuberculosis among schoolchildren in an epidemiologically unfavorable region]. / Puti profilaktiki i rannego vyiavleniia tuberkuleza sredi shkol'nikov na épidemiologicheski neblagopoluchnoi sel'skoi territorii.

Attention is attached to the improvement of health education in school collectives in the epidemiologically unfavourable rural areas. The level of their awareness of tuberculosis prevention has been studied on the basis of questionnaires given to 153 teachers and 90 schoolchildren and hence the optimal forms of activity have been suggested, including lesions in tuberculosis prevention that should be included in the curriculum of biology. Variants of tuberculin diagnosis used in early tuberculosis detection and adequate formation of risk groups in the presence or absence of a contact with tuberculosis patients in school collectives have been proposed. Special consideration is given to these activities in rural boarding schools.

[The role of tuberculin test and fluoroscopy in detecting intra- thoracic tuberculosis in children and adolescents living in the rural area with high incidence of tuberculosis]. / Rol' tuberkulinodiagnostiki i fliuorografii v vyiavlenii vnitri- grudnogo tuberkuleza u detei i podrostkov v épidemiologicheski neblagopoluchnom po tuberkulezu sel'skom raione.

The analysis of 91 case records of children and adolescents living in rural area with a high incidence of tuberculosis was made. These patients were detected through screening and by means of tuberculin diagnosis and fluorography carried out by a team of health workers on a case-finding mission. The organization of work with due regard for the local conditions makes it possible to use the above methods for an early detection of the given disease; to assess the results obtained from the very beginning of their combined and parallel application; to practice fluorography from the age of 7; to exercise a differentiated approach to an additional examination depending on the distance between the population area and regional center; and optimize health record handling.

[Risk factors of primary tuberculosis infection in children and adolescents]. / Faktory riska pervichnogo infitsirovaniia tuberkulezom detei i podrostkov.

Characteristic features of subjects of the VIA registration group (500 children and adolescents) observed by one of the Moscow children's polyclinic from 1983 to 1987 are given. The rate of primary contamination amounted to an average of 0.75% a year. 92.8% of children and adolescents were infected as a result of an unknown contact, while 7.2% of them had contact with relatives suffering from tuberculosis. In case of conversion of tuberculin reactions, hypersensitivity to tuberculin was seen in 12.2% of the patients and a year later in 4.6% the subjects with persistent hyperergy who were then transferred to the VIB registration group. The following risk factors of contaminating and contacting tuberculosis were found: contact with tuberculosis patients; immunization of poor quality or its absence; hypersensitivity to tuberculin; frequent acute respiratory viral infections and chronic diseases; and unfavourable social and living conditions. The number of these factors should be taken into account since with their growth, the rate of hyperergy and risk of developing the disease are higher. More thorough examination and controlled preventive chemotherapy at a sanatorium are required when 2 or more risk factors are available.