Integrated Approach to Diagnostic Tuberculosis in Today’s Conditions (Review)

The analysis of professional publications of global and Ukrainian experience regarding the diagnosis of tuberculosis patients was carried out. The analysis of literary sources of recent years shows that tuberculosis remains an urgent problem in Ukraine. The situation in Ukraine today will contribute to the growth of morbidity and mortality rates from tuberculosis, the progression of this disease.Thorough examination of all contact children and adolescents in centers of tuberculosis infection is recommended: history study, tuberculin diagnostics (quantiferon test), clinical, radiological and micro­biological examination for timely detection of tuberculosis (or infection). The tuberculin Mantoux test and interferon-gamma release assays are useful for detecting latent tuberculosis infection.A multidisciplinary approach and conducting a complex of clinical, laboratory, pathohistological and the latest diagnostic instrumental studies make it possible to carry out differential diagnosis. Patients in whom tuberculosis is diagnosed using microbiological methods more often live in rural areas with low availability of medical services. Patients in whom tuberculosis is diagnosed using a radiological method more often live in the city and are involved in an active screening program.A separate direction is the analysis of modern minimally invasive methods of obtaining biopsies. Timely acquisition of lung biopsy material for morphological examination makes it possible to establish the correct diagnosis in case of its dissemination. A comprehensive approach in the diagnosis of granulomatous lesions of the lungs in patients with HIV infection/AIDS improves the verification of the etiological factor. The informativeness of the methods of diagnosing tuberculosis in HIV-infected persons was studied: the most informative method was culture (54 %), radiological was informative in 27 % of cases.For the final identification of mycobacteria (specificity), the genetic test system GenoType MTB DR (Hain, Laifsains) is used, which makes it possible to differentiate mycobacteria of the tuberculous and non-tuberculous complex in sputum patients. With the help of mathematical modeling, the approximate number of undetected tuberculosis patients during the period of quarantine measures was calculated and a forecast of a significant increase in the incidence of tuberculosis in the next few years was given, which will lead to an increase in the number of neglected forms of tuberculosis (in particular, non-pulmonary).