Piskur Z. Diagnostics and prognosis of the course of extrapulmonary tuberculosis combined with specific respiratory damage in children

Object of study: extrapulmonary tuberculosis (EPTB) combined with pulmonary tuberculosis (TB) in children; the aim – to development a model for predicting the likelihood to development of EPTB in children and the algorithm for its diagnosis on the basis of the study of pathomorphosis, structure, risk factors and features of the clinical course; methods of investigation: clinical, rentgenological, microbiological, morphological, immunological and statistical; the novelty: new scientific data on peculiarities of EPTB pathomorphosis in children of Lviv region for 28 years have been received; it was established that during this period there was a decrease in the proportion of EPTB, however, the percentage of TB of the membranes and the central nervous system and TB of another localization increased; the structure of EPTB and its clinical features in modern conditions are determined; clarified scientific data on the risk factors for the development of EPTB in children: low alertness of general network physicians for EPTB, detection of children during treatment, poor quality of tuberculin diagnostics, untimely detection and taking on dispensary surveillance, untimely detection of sources of infection; the peculiarities of seasonal fluctuations of TB disease in children of different ages, sex, and the effectiveness of BCG vaccination were first determined; it was determined that seasonal fluctuations during the EPTB were expressed in the summer; it has been shown that in children with combined EPTB forms, vitamin D deficiency was observed twice as often as in children with pulmonary tuberculosis, indicating the linkage of the severity of the disease to the level of vitamin D; received data on the activation of proinflammatory cellular response in response to mycobacterial antigens; the prognostic model of the probability of progression of pulmonary tuberculosis and the proposed algorithm for diagnosis of EPTB, which increase the ability to detect TB and prevent the development of its complicated forms in children, is developed. Scope - medicine.