Phthisiology

doi: 10.25005/2074-0581-2018-20-2-3-305-308
MODERN DIAGNOSTIC METHODS OF TUBERCULOUS MENINGITIS AMONG CHILDREN'S POPULATION

B.P. Sharipov1, D.M. Yusupdzhanova1, U.Yu. Sirodjidinova2, D.M. Ibragimova1

1Republican Center for Protection of Population from Tuberculosis, Dushanbe, Republic of Tajikistan
2Department of Phthisiopulmonology of the Avicenna Tajik State Medical University, Dushanbe, Republic of Tajikistan

Objective: To study the influence of new methods of diagnostics on the timeliness of the diagnosis verification for tuberculosis meningitis.

Methods: 33 case histories of children were studied at aged 4-17 years with tuberculous meningitis who were hospitalized at the Children's Tuberculosis Hospital in Dushanbe from 2009 to 2017 years. The boys were 22 (66%), girls – 11 (34%); of the villagers – 24 (70.3%), the city – 11 (29.7%).

Results: All sick children were identified by treatment in the first two weeks from the onset of the disease, with expressed clinical symptoms of meningitis. 16 (48.4%) of children were from foci of tuberculosis infection. In 23 (70%) children, there was no scar after vaccination with BCG. X-ray findings: all had local tuberculosis of the lungs, including 20 cases of miliary tuberculosis. Of the 20 patients with miliary tuberculosis, 6 (33.3%) had positive MTB in the sputum, 8 of the examined MTB were not microscopically detected in the liquor. When studying by molecular genetic method on XpertMTB/RIF, 9 (45%) of 20 patients were found in the sputum, and 4 (50%) of 8 examined in MTB were found in liquor. Of 4 MTB liquor positive, two were stable and two were sensitive to rifampicin.

Conclusions: The molecular-genetic method of XpertMTB/RIF promotes an accelerated method of verifying the diagnosis of tuberculous meningitis.

Keywords: Tuberculous meningitis, express diagnostics, XpertMTB/RIF.

Download file:


References
  1. Pirov KI, Sirodjidinova UYu, Bobokhojaev OI, Zachariah R. Sluchay tuberkuloyza u detey v g. Dushanbe, Tadzhikistan [Cases of tuberculosis in children in Dushanbe, Tajikistan]. Zhurnal Evropeyskogo regional’nogo byuro VOZ «Panorama». 2016;2(1):89-92.
  2. Sirоdjidinova UYu, Bobokhojaev OI, Dustmatova ZSh, Mirzoeva FO, Pirov KI. Analiz situatsii po tuberkulyozu v Respublike Tadzhikistan [Analysis of the situation of tuberculosis in the Republic of Tajikistan]. Tuberkulyoz i bolezni lyogkikh. 2015;2:39-40.
  3. Sirodjidinova UYu, Sharipov BP, Pirov KI. Vliyanie vaktsinacii BTSZH na strukturu klinicheskikh form tuberkulyoza u detey [Influence of BCG vaccination on the structure of clinical forms of tuberculosis in children]. Tuberkulyoz i bolezni lyogkikh.2014;8:39.
  4. Global TB Report. WHO: Geneva;2016. 422 p.
  5. Maslova OV, Kiselevich ОК, Vlasova ЕЕ. Pervichnyy tuberkulyoz u detey rannego vozrasta iz semeynogo kontakta [Primary tuberculosis in infants from a family contact]. Tuberkulyoz i bolezni lyogkikh. 2014;8:67-8.
  6. Kufakova GA, Ovsaynkina EG. Faktory riska razvitiya zabolevaniya tuberkulyozom u detey i podrostkov iz sotsial’no-dezadaptirovannikh grupp naseleniya [Risk factors for the development of tuberculosis in children and adolescents from socially-depressed populations]. Bol’shoy tselevoy zhurnal. 2008;1:29-30.
  7. Galimzyanov KhM, Streltsova EN, Cherenova LP, Kuraytnikova GK. Techenie tuberkulyoznogo meningita v sovremennykh usloviyakh sredi vzroslogo naseleniya [The course of tuberculous meningitis in modern conditions among adults]. Tuberkulyoz i bolezni lyogkikh. 2015;5:66-7.
  8. Minoranskaya NS, Minoranskaya EI. Znachenie vospalitelnykh markyorov dlya differentsial’noy diagnostiki razlichnykh form ostrykh iksodovykh kleshchevykh borreliozov [The importance of inflammatory markers for differential diagnosis of various forms of acute ixodid tick-borne borreliosis]. Sovremennye problemy nauki i obrazovaniya. 2014;1:23-8.
  9. Lozovskay ME, Osipova МА, Suslova GA, Bykova VV, Karasyov GG, Bykova AI. Novoe v organizatsii sanatorno-reabilitatsionnoy pomoshchi detaym i podrostkam s tuberkulyoznoy infektsiey [News in the organization of sanatorium-rehabilitation care for children and adolescents with tuberculosis infection]. Tuberkulyoz i bolezni lyogkikh. 2017;1:22-6.
  10. Baryshnikova LA. Tuberkulyoz u detey mladshego vozrasta v Samarskoy oblasti [Tuberculosis in young children in the Samara region]. Tuberkulyoz i bolezni lyogkikh. 2013;6:15-6.
  11. Martynova AV, Turkutukov VB. Epidemiologicheskiy analiz zabolevaemosti invazivnymi i neinvazivnymi formami pnevmokokkovykh infektsiy v razlichnykh gruppakh naseleniya [Epidemiological analysis of incidence of invasive and non-invasive forms of pneumococcal infections in different population groups]. Vestnik RAMN. 2007;9:12-6
  12. Kharchenko GA, Kimirilova OG, Chabanova ON. Tuberkulyoznyy meningit u detey i podrostkov [Tuberculous meningitis in children and adolescents]. Tuberkulyoz i bolezni lyogkikh. 2017;1:47-50.
  13. Barkanova ON, Gagarina SG, Kaluzhenina АА. Tuberkulyoz mozgovykh obolochek: diagnostika, klinicheskoe techenie, reabilitatsiya [Tuberculosis of meninges: diagnosis, clinical course, rehabilitation]. Lechenie i profilaktika. 2015;4:73-6.
  14. Mardanly SG, Pervushin UV, Ivanova VN. Spinomozgovaya zhidkost’, laboratornye metody issledovaniya i ikh kliniko-diagnosticheskoe znachenie: uchebnoe posobie dlya spetsialistov po klinicheskoy laboratornoy diagnostike [Cerebrospinal fluid, laboratory methods of investigation and their clinical and diagnostic value: A manual for specialists in clinical laboratory diagnostics]. Zhurnal «EKOlab». 2011;1:72.
  15. Brazhenko NA (red.) Vnelyogochnyy tuberkulyoz: rukovodstvo dlya vrachey [Extrapulmonary tuberculosis: a guide for doctors]. Saint Petersburg, RF: SpetsLit; 2013. 395 p.
  16. Borzenko AS, Gagarina SG, Shmelyov EN, Kaluzhenina АА. Osobennosti klinicheskogo techeniya i diagnostiki tuberkulyoznogo meningita u detey v Volgogradskoy oblasti [Features of the clinical course and diagnosis of tu-berculous meningitis in children in the Volgograd region]. Vestnik VolgG-MU. 2012;2:101-4.
  17. Klochkova LV, Lozovskaya ME, Vasilyeva EB, Zakharova OP. Techenie i iskhody tuberkulyoznogo meningita u detey na sovremennom etape [The course and outcomes of tuberculous meningitis in children at the present stage]. Tuberkulyoz i bolezni lyogkikh. 2015;7:68-9.

Authors informations:

Sharipov Bobodzhon Pirmakhmadovich, Deputy Director of the Republican Center for the Protection of the Population from Tuberculosis

Yusupdzhanova Dzhema Mukhamedzhanovna, Candidate of Medical Sciences, Phthisiatrician, Republican Center for the Protection of the Population from Tuberculosis

Sirodjidinova Umrniso Yusupovna, Doctor of Medical Sciences, Full Professor, Professor of the Department of Phthisiopulmonology, Avicenna Tajik State Medical University

Ibragimova Dilfuza Makhmadovna, Phthisiatrician, Republican Center for the Protection of the Population from Tuberculosis

Address for correspondence:

Sharipov Bobodzhon Pirmakhmadovich

Deputy of the Republican Center for the Protection of the Population from Tuberculosis

734025, Republic of Tajikistan, Dushanbe, Bukhoro str., 53

Tel.: (+992) 900 007444

E-mail: sharipovbobojon07@gmail.com

Materials on the topic: