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OPINION
Ethical dilemmas in diagnosis and management of latent tuberculosis infections in children
Yaroslavl State Medical University, Yaroslavl, Russia
Correspondence should be addressed: Olga G. Chelnokova
Revolutsionnaya St., 5, Yaroslavl, 150000, Russia; ur.kb@avokonlehc
Author contribution: Chelnokova OG — consultations with patients, study of related literature, systematization and generalization of data, participation in the discussion of the results, writing and formatting of the article; Khokhlov AL — problem statement, discussion of key ethical issues, planning and discussion of the article; Mozzhukhina LI — studying the literature on the topic, participating in the discussion of the results and writing an article; Salova AL — consultations with patients, study of related literature, participation in the discussion of patients and results, writing an article.
Compliance with ethical standards: the meeting of the ethics committee was not held because it is experience of ethically observing patients in real clinical practice that has been discussed.
In latent tuberculosis infection (LTBI), there are no clinical or radiographic symptoms of active tuberculosis (TB), although immunological tests are positive. Meanwhile, the risk of progression from LTBI to active TB remains high, especially in children. It is estimated that a quarter of the world’s population has LTBI. Identifying LTBI as a predictor of active TB represents a major public health achievement, as preventive activities can help stop the spread of TB in many cases. Phthisiologists specialize in the diagnosis, monitoring, and treatment of children with LTBI. Because the process is prolonged, pediatricians actively monitor and care for somatic issues in children with LTBI. During examination and treatment, both doctors and patients — together with their parents — may encounter numerous ethically challenging situations that significantly affect the quality of medical care and treatment outcomes for children with LTBI.
Keywords: children, ethical issues, latent tuberculosis infection, rejection of diagnosis