Evaluation of Effectiveness of Tuberculin Skin Test Screening Programme in Lithuania - EAP 2019 Congress and MasterCourse Porto Palacio Hotel

Ginreta Valinciute Izabele Juskiene ³ Algirdas Valiulis ⁴

¹Vilnius University Medical Faculty, Institute of Health Sciences, Department of Public Health, Lithuania
²National Public Health Center, Department of Communicable Diseases Management, Lithuania
³Vilnius University Medical Faculty, Institute of Clinical Medicine, Clinic of Children‘s Diseases, Lithuania
⁴Vilnius University Medical Faculty, Institute of Clinical Medicine, Department of Rehabilitation, Physical and Sports Medicine, Lithuania
⁵Vilnius City Clinical Hospital, Clinic of Children‘s Diseases, Lithuania

Background: The incidence of tuberculosis (TB) in Lithuania is one of the highest in the European Union. According national legislation the BCG vaccine is given obligatory during first 3 days after the birth and tuberculin skin test (TST) carried out for all children of 7-years-old and higher TB risk children at different age (not vaccinated children, TB contacts, children from social risk families including migrants, etc.).

Objective: The aim of the research was the assessment of the effectiveness of TST screening program of 7-year-old children and children of higher TB risk groups in Lithuania.

Material and Methods: The retrospective descriptive analysis of the use of TST in Lithuania between 2013 and 2018 was conducted. The data are processed by SPSS 22.0 program, the difference between the compared groups is considered significant when p≤0.05.

Results: In the period of 2003 to 2017 BCG vaccination coverage was 98.5 perc. and it was the highest rate in the Baltic States. From 2013 to 2018 TST was performed in 123936 (72.4 perc.) of all 171284 7-years-old Lithuanian children and in TB contact group TST was performed in 14045 of 14414 (97.4 perc.) children. The positive TST was more common in TB contacts than in 7-year-old children (χ² = 6220.5; p 0.001). The detection of positive TST is more often in contacts than in group of 7-year-old children (risk ratio – 3.71; 95 perc. CI 3.59, 3.83). Positive TST was detected in 9593 (7.7 perc.) of 7-year-old children and 4029 (28.7 perc.) of TB contact children. The same trend was observed when calculating positive TST of children from social risk families. It was found more often positive TST in social risk group children (χ² = 484.2; p 0.001; risk ratio – 1.67; 95 perc. CI 1.60, 1.75), if compare with the group of 7-year-old children.

Conclusions: The obligatory national TST screening for tuberculosis infection in the group of 7-year-old children is not cost effective and clinically relevant. TST screening programme should focus on risk group children only.