Preventive treatment of latent tuberculosis infection in persons living in social welfare homes due to mental pathology
https://doi.org/10.54921/2413-0346-2024-12-2-18-24
Abstract
Aim. To evaluate the safety and effectiveness of preventive treatment of latent tuberculosis infection in people living in social welfare homes due to mental pathology.
Methods. 121 patients with latent infection living in social welfare homes were included in prospective study, 79 men and 42 women aged 25–90 years. The choice of preventive therapy regimen was made according comorbidities and the risk of interactions between antituberculosis drugs and psychopharmacotherapy. The incidence of adverse reactions, the dynamics of skin tests results and tuberculosis morbidity during two years of follow-up were evaluated.
Results. 119 patients received preventive treatment: isoniazid for 6 months (n = 47) or isoniazid and pyrazinamide for 3 months (n = 72). The incidence of adverse reactions was 5.9% (95% CI 2.4–10.8%), 10.6% in the isoniazid group, 2.8% in the isoniazid plus pyrazinamide group (p > 0.05). In the first year of follow-up, skin test reactions decreased in 62.4% of patients and became negative in 9.9%; in the second year − in 40.1% and 1.9%, respectively; the number of persons with hyperergic reactions decreased 3.4 times. No cases of active tuberculosis were detected.
Conclusion. In patients with latent tuberculosis infection living in social welfare homes due to mental pathology, preventive therapy with isoniazid (6 months) or isoniazid and pyrazinamide (3 months) is advisable.
About the Authors
E. T. Khalafova
The Moscow Research and Clinical Center for Tuberculosis Control of the Moscow Government Department of Health
Russian Federation
Russian Federation
E. M. Bogorodskaya
The Moscow Research and Clinical Center for Tuberculosis Control of the Moscow Government Department of Health;
Federal State Budgetary Educational Institution of Additional Professional Education «Russian Medical Academy of Continuing Professional Education» of the Ministry of Health of the Russian Federation, Department of Phthisiology
Russian Federation
Russian Federation
T. N. Ivanushkina
The Moscow Research and Clinical Center for Tuberculosis Control of the Moscow Government Department of Health
Russian Federation
Russian Federation
References
1. Богородская Е.М., Мохирева Л.В., Мусаткина Н.В., Белиловский Е.М., Ли-Чин-Вин И.В., Просвирнина Ю.А. Распространенность латентной туберкулезной инфекции у работников медицинских организаций // Туберкулез и социально значимые заболевания. – 2023. – Т. 11. – № 1 (41). – С. 4-12.
2. Зубова Е.Ю. Туберкулез легких у больных с психическими расстройствами // Медицинская газета. – 2008. – № 58. – С. 8-9.
3. Крикова А.В., Крутикова Н.Ю., Тещенков А.В. Риск развития нежелательных реакций при профилактическом приеме противотуберкулезных препаратов у детей с латентной инфекцией // Практическая медицина. – 2021. – № 1. – С. 34-37.
4. Клинические рекомендации по диагностике латентной туберкулезной инфекции, химиопрофилактике заболевания в группах риска у взрослых / Утв. 03.11.2015 на заседании МОО «Московское общество фтизиатров» // Туберкулез и социально значимые заболевания. – 2017. – № 1. – С. 28-59.
5. Мосолов С.Н. и др. Лекарственные взаимодействия препаратов, применяемых в психиатрической практике // Современная терапия психических расстройств. – 2019. – № S1. DOI: 10.21265/PSYPH.2019.50.40828
6. Практические рекомендации для национальных программ по борьбе с туберкулезом по внедрению и использованию комбинированных противотуберкулезных препаратов с фиксированными дозами / Всемирная организация здравоохранения. – 2002. – 89 с. http://www.who.int/tb/
7. Руководящие принципы для интенсивного выявления туберкулеза и профилактической терапии изониазидом у людей, живущих с ВИЧ, в условиях нехватки ресурсов. – Женева: ВОЗ, 2011. [доступ 9 августа 2015]. http://who.int/publications/2011/9789244500705_rus.pdf
8. Федеральные клинические рекомендации по диагностике и лечению туберкулеза. – Прил. 5. – 2022. – С. 96.
9. Doherty A.M., Kelly J., McDonald C., O‘Dywer A.M., Keane J., Cooney J. A review of the interplay between tuberculosis and mental health // Gen. Hosp. Psychiatry. – 2013. – Vol. 35, № 4. – P. 398-406. doi: 10.1016/j.genhosppsych. 2013.03.018. Epub 2013 May 6. PMID: 23660587.
10. Erkens C.G.M., Kamphorst M., Abubakar I., Bothamley G.H., Chemtob D., Haas W., Migliori G.B., Rieder H.L., Zellweger J-P., Lange C. Tuberculosis contact investigation in low prevalence countries: a European consensus // Eur. Respir. J. – 2010. – Vol. 36, № 4. – P. 925-949. doi: 10.1183/09031936.00201609.
11. Faber M.S., Jetter A., Fuhr U. Assessment of CYP1A2 activity in clinical practice: why, how, and when? // Basic & Clinical Pharmacology & Toxicolog. – 2005. – Vol. 97, № 3. – P. 125-134. DOI:10.1111/j.1742-7843.2005
12. Menzies R., Vissandjee B., Rocher I. et al The booster effect in two-step tuberculin testing among young adults in Montreal // Ann. Intern. Med. – 1994. – Vol. 120. – P. 190-198.
13. WHO operational handbook on tuberculosis. Module 1. Tuberculosis preventive treatment. – Geneva: World Health Organization, 2021. Available: https://apps.who.int/iris/bitstream/handle/10665/331525/ Accessed September 12, 2020.
Review
For citations:
Khalafova E.T., Bogorodskaya E.M., Ivanushkina T.N. Preventive treatment of latent tuberculosis infection in persons living in social welfare homes due to mental pathology. Tuberculosis and socially significant diseases. 2024;12(2):18-24. (In Russ.) https://doi.org/10.54921/2413-0346-2024-12-2-18-24
Views:
647
Email this article 