Coronavirus disease has disrupted tuberculosis services globally. Data from 33 centers in 16 countries on 5 continents showed that attendance at tuberculosis centers was lower during the first 4 months of the pandemic in 2020 than for the same period in 2019. Resources are needed to ensure tuberculosis care continuity during the pandemic.

Treatment interruptions were frequent in TB patients in the six Russian regions. Interventions to improve treatment adherence in patients are necessary. Social support and incentive programs should be universally available for all patients from the start of the continuation phase of treatment, during the intensive phase for patients considered to be at risk for default, and for those patients who have missed at least 2-3 days of treatment during the intensive phase. Directly observed therapy (DOT) at home could be a recommendation for some patients.

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ГБУЗ города Москвы «Московский городской научно-практический центр борьбы с туберкулезом Департамента здравоохранения города Москвы»,

BackgroundA group of Russian scientists has developed Diaskintest, which comprises Mycobacterium tuberculosis-specific recombinant proteins CFP10-ESAT6, for skin testing (0.2 μg/0.1 ml).Study purposeTo evaluate the comparative sensitivity of TST with 2 TU PPD-L and a skin test with tuberculous recombinant allergen (Diaskintest) containing the ESAT6-CFP10 protein in children and adolescents with newly diagnosed active tuberculosis during mass screening in the primary medical service in Moscow.Materials and methodsThe trial was a comprehensive retrospective group study of children and adolescents diagnosed in Moscow with active tuberculosis in 2013–2016, aged 0 to 17 years inclusive.ResultsFrom 441 patients selected for analysis 408 patients had both tests (TST with 2 TU PPD-L and Diaskintest) performed, in 193 patients both tests were given simultaneously, of them 162 patients were BCG-vaccinated. Comparative results of both tests in 408 patients with tuberculosis: at cut-off ≥ 5 mm, both tests has similar sensitivity: Diaskintest 98.3% (95% CI 97.0–99.6%), TST 98.0% (95% CI 96.7–99.4%), at cut-off ≥10 mm, the sensitivity decreases for both tests: Diaskintest 90.0% (95% CI 87.0–93.0%), TST 88.7% (95% CI 85.6–91.9%), but at cut-off ≥ 15 mm, the decrease in sensitivity is statistically significant: for Diaskintest 61.5% (95% CI 56.7–66.3%), and for TST 46.3% (95% CI 41.4–51.3%), p <0.0001.The results of simultaneous setting of tests on different hands in 193 people (including 162 BCG-vaccinated), do not differ from the results for 408 people.The correlation between the results of Diaskintest and TST was significant in all groups.ConclusionIn children and adolescents with active tuberculosis, Diaskintest of 0.2 μg/ml and the Mantoux test with 2 TU PPD-L have high sensitivity (98%) at a cut-off of 5 mm; however, at cut-off ≥ 15 mm sensitivity is significantly reduced, and the decrease is more pronounced in the Mantoux test. The advantage of Diaskintest is that, unlike the Mantoux test, it has high specificity under the conditions of mass BCG vaccination. The test is simple to carry out, and can be used in mass screening.