Аннотация

Цель
To describe a tuberculosis (TB) outbreak and anti-epidemic measures at University X, located in the capital of the Republic of Tajikistan.
Материал и методы
Data sources included TB case registration journals, dispensary follow-up lists, TB notification forms, and medical records of TB patients and individuals with latent tuberculosis infection (LTBI) from University X.
Результаты
On December 8, 2022, a 19-year-old female student from University X presented to the City Center for Tuberculosis Control with complaints of a one-month history of cough, fever, night sweats, loss of appetite and weight, and weakness. The GeneXpert MTB/Rif test result was positive, with drug sensitivity detected; sputum smear microscopy for acid-fast bacilli (AFB) — ++; the GenoType MTBDRplus test was positive, showing sensitivity to rifampicin and isoniazid. Diagnosis: Infiltrative tuberculosis of the lower lobe of the right lung with cavitation. AFB positive. Treatment with the regimen 2HRZE/4HR was initiated in an inpatient setting. A total of 935 contacts, including faculty, students, and other university staff, were screened using a portable X-ray device with computer-assisted image analysis, as well as tuberculin skin tests - Mantoux test with 2 TU PPD-L and Diaskintest (Generium, Russian Federation). As a result, 7 TB cases were identified, including 2 faculty members with comorbid diabetes mellitus and 5 students. Latent TB infection was diagnosed in 72 students and faculty members; preventive treatment regimens included 3HR for 9 individuals and 3HP for 63 individuals. LTBI treatment was completed by 71 patients; in one case, peripheral lymph node tuberculosis was diagnosed during preventive therapy. All patients with active TB successfully completed treatment with favorable outcomes. No reactivation of tuberculosis was observed during the two years of follow-up.
Заключение
Timely detection of the index case, active contact investigation, and organization of preventive treatment helped prevent further spread of infection. The detection of tuberculosis in faculty members with comorbid diabetes highlights the need for particular attention to risk groups, as comorbidities increase the likelihood of developing active TB. The high prevalence of latent infections underscores the importance of chemoprevention among students and staff, which contributes to reducing the potential reservoir of infection in the population.

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