Comparison of The Diagnosis Peculiarities of Familial Tuberculosis

Abstract

Objective — to compare the diagnostic features of individuals with family tuberculosis within the context of reorganizing the tuberculosis control service. Materials and methods. The study involved the analysis of diagnostic results and management of 406 patients within a cluster of family tuberculosis. Among them, 207 patients were identified as the source of tuberculosis (comparison group), and 199 were contacts who contracted the disease from individuals in the comparison group. Patients in the comparison group were examined by family doctors, while contacts were evaluated by phthisiologists. Results and discussion. Patients in the comparison group served as carriers of pulmonary tuberculosis in 201 (97.1 %) cases and extrapulmonary tuberculosis in 6 (2.9 %) cases. Concurrent illnesses were detected in 114 (55.1 %) individuals. Upon consulting family doctors within the first 5 days of examination, the diagnosis was not established in the comparison group. However, within 20 days, it was verified in 164 (79.2 %) patients. In the main group, pulmonary forms of the disease were observed in 173 (86.9 %) patients, while extrapulmonary forms were present in 26 (13.1 %). Diagnosis was established within 5 days in 94 (47.2 %) individuals and within 10 days in 77 (37.7 %). Overall, within the first 10 days, pulmonary diagnosis was verified in 173 (86.3 %) patients in the main group, as opposed to 18 (8.7 %) in the comparison group, representing a 9.9-fold difference (p < 0.001). Conclusions. Given that 114 patients in the comparison group had concurrent illnesses over many years, their tuberculosis manifestation was treated as «known» to the patient and the attending physi­cian, leading to a delay in diagnosing pulmonary tuberculosis by more than 20 days. Patients in the main group sought medical attention by reporting contact with tuberculosis patients, resulting in consultations with phthisiologists and, consequently, a 9.9-fold faster verification of pulmonary tuberculosis. Screening of individuals suspected of tuberculosis should be promptly conducted by phthisiologists.