The informative value of diagnostic tests in urogenital tuberculosis screening
Shevchenko S.Yu.^1,2, Kulchavenya E.V.^1,2, Laushkina Zh.A.<sup>1

1</sup> Novosibirsk Research Institute of Tuberculosis 
² Novosibirsk State Medical University

Despite a slight decrease in the share of urinogenital tuberculosis (UT) in the structure of the incidence rate of extrapulmonary forms of tuberculosis, its medical, epidemic and social significance is great. Urinogenital tuberculosis (UT) is characterized by polymorphism of clinical manifestations and the absence of pathognomonic symptoms, which significantly complicates its recognition. 
The aim of the study was to determine the informative value of the recombinant tuberculosis antigen in standart dilution (RTA) as a screening method in the differential diagnosis of UT.
Patients and methods. A simple open cohort study was conducted. It included 126 patients who received treatment the extrapulmonary tuberculosis department of the Novosibirsk Research Institute of Tuberculosis in 2014-2015. Patients were divided into three groups: group 1 - patients with active UT, n = 31 (24.6%); group 2- patients with inactive UT, n = 16 (12.7%); group 3 - patients with chronic infections of the urogenital tract with excluded UT, n = 79 (62.7%). The comparison group included 105 patients aged from 18 to 78 years hospitalized with suspected respiratory tuberculosis (RT). In addition to the standard clinical-laboratory, X-ray and bacteriological examination, they all had a skin test with RTA.
Results. The RTA sensitivity in adult patients with pulmonary tuberculosis was 74.5%, the RTA specificity in RT was 86%. RTA sensitivity in patients with active UT was 78.6%, and sensitivity of subcutaneous challenge tuberculin test was 82.8%. Thus, the false positive result of RTA in patients without tuberculosis was 76.9%, and there were no any false positive results of Koch’s test, which indicates an extremely low specificity of RTA (23.1%) for urogenital tuberculosis in adults.
Conclusions. RTA can be used in UT screening, though its positive result cannot be used as a basis for establishing a diagnosis, but only as a reason for an additional phthisiourological examination.

Key words: tuberculosis, diagnostics, recombinant tuberculosis antigen in standart dilution, Koch’s test, urinogenital tuberculosis.
For citation: Shevchenko S.Yu., Kulchavenya E.V., Laushkina Zh.A. The informative value of diagnostic tests in urogenital tuberculosis screening // RMJ. 2017. № 27. P.2007 –2010.