The importance of the diagnosis and treatment of latent tuberculosis infection on the tuberculosis control

Simonovska, Ljiljana and Paneva, Iva (2019) The importance of the diagnosis and treatment of latent tuberculosis infection on the tuberculosis control. Knowledge - International Journal, Scientific Papers, 30.4. pp. 87-91. ISSN 2545-4439

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Latent tuberculosis infection (LTBI) is defined as a condition of a permanent immune response stimulated
by tuberculosis mycobacteria (TB) antigens without the presence of a clinical manifest active disease It is estimated
that 2 billion people, or one third of the world's population, are latently infected with TB bacteria During life, the
risk of reactivation of TB in people with confirmed LTBI is 5-10%, and that most will develop illness during the
first five years after the initial infection .The systematic detection and treatment of LTBI is an important component
of the World Health Organization's new "End of TB" strategy (WHO). To diagnosis of latent tuberculosis infection
both tests are used: Tuberculosis skin test (TST), and QuantiFERON-TB(QFT-Quantiferone) which belongs to the
group of the IGRA tests (interferon -gama release assay). Indications for diagnosis and treatment are: family
contacts from 0 to14 years, infants , children and adults carriers of HIV virus and other people with medical risk
factors. For the treatment of LTBI, in our country, the standard 6 month regime with Isoniazid, and as an alternative,
a 3 month regimen with Isoniazid and Rifampicin are administered. 9- month regime with Isoniazid is applied in
people with HIV infection. In 2017, in our country, 45 people with LTBI were examined and treated. 41 (91%)
were family contacts with pulmonary smear positive tuberculosis and in 4 (9%) who were with-medical risk factors
for the treatment of LTBI (HIV positives, or people who were treated with anti-TNF therapy). For the diagnosis of
LTBI, two tests were applied .In 9 (20%) QuantiFERON-TB and by all examined was positive, that confirms the
fact of greater sensitivity in comparison with TST. At 41, TST was made, of which 20 or 46% was positive. The LTI
treatment was implemented with two regimes , 24 (54%) were treated with a six- months daily regime with INH
(Isoniazid), and 21 (46%) with a three-month daily regime with two anti-tuberculosis drugs (INH and Rifadin ).
Those who were HIV positive treatment with INH were administered for 9 months. According to the outcome of the
treatment, in 28 (62%) the treatment is completed, and in 17 (38%) was discontinued due to non-cooperation, and
due to the control negative results of TST
Conclusion: The diagnosis and successful treatment of LTBI is an important component of the new strategy for the
WHO "End of TB". The low percentage of successfully treated persons with LTBI in our country, in 2017 (62.2%)
imposes the need to improve the management of persons with LTBI, with the aim of achieving its eradication

Item Type: Article
Subjects: Medical and Health Sciences > Clinical medicine
Medical and Health Sciences > Health biotechnology
Medical and Health Sciences > Health sciences
Divisions: Faculty of Medical Science
Depositing User: Gordana Panova
Date Deposited: 23 Apr 2019 09:02
Last Modified: 23 Apr 2019 09:02

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