Tuberculosis in adolescents and young patients in high prevalence region.

The study aims to determine what forms of tuberculosis (TB) are the most common in high prevalence region, establishes the drug sensitivity of Mycobacterium tuberculosis in the region, and reveals the key risk factors of the disease as well as assesses the health status of adolescents with tuberculosis. For 10 years, regional anti-tuberculosis hospital in Smolensk has been collecting data from all TB patients aged 14-34 years. Diagnosis of tuberculosis was based on specific radiological data and detection of M. tuberculosis in sputum or bronchial lavage fluid. In total, the study involved 129 TB cases in adolescents aged 14-17 and 420 TB cases in young people. Sixty-five adolescents had close family or periodic contact with TB patients (50.6%), but only eight out of 65 (12%) had received complete course of chemistry prevention. Sixty-two adolescents had social risk factors (48%). Those patients significantly more often had extended pulmonary TB (28.3% versus 16.7%), complicated (36.7% versus 16.9%), and destructive (41.7% versus 26.2%) cases. Eighty out of the 129 (62%) had one or more concomitant diseases; they had significantly higher rate of extended and complicated TB cases. Two hundred and fourteen out of the 420 young patients had drug resistance of M. tuberculosis. Resistant TB cases significantly more often developed in unemployed (83.2% versus 71.8%), heavy drinkers and smokers (59.3% versus 43.7%), and in ex-prisoners (26.6% versus 15%). In conclusion, a comprehensive approach to examination and treatment of adolescents with TB should be performed. History and clinical data can be beneficially used to predict of drug resistance before results of cultural investigation.