EPIDEMIOLOGICAL, BIOLOGICAL HISTORY AND SOCIAL STATUS OF CHILDREN WITH PROGRESSION OF LTBI TO ACTIVE TUBERCULOSIS

Аннотация

From today's perspective, there are no gold standards for early detection of LTBI and differential diagnosis between latent and active tuberculosis infection in a child. Purpose of the study: to study the structure of somatic pathology and features of the epidemiological history during the development of LTBI and its progression in children. Materials and methods: A retrospective-prospective cohort study was conducted in accordance with the international STROBE standard. 60 children were selected and divided into three groups: Group 1 included 40 children with latent tuberculosis infection, Group 2 included 20 children with active tuberculosis. Group 1 is divided into: subgroup I, consisting of 20 children in whom the progression of LTBI to active tuberculosis was established and subgroup II, consisting of 20 children in whom progression of LTBI to active tuberculosis did not occur. Results and discussion. The decisive social risk factors were the child’s residence in a low-income (RR 5,000), large (RR 4,667), or single-parent family (RR 3,200), unsatisfactory living conditions for the child and his family (RR 4,857), and the father’s lack of permanent employment ( RR 3.467), secondary or secondary specialized level of education among parents (RR 3.000), maternal unemployment (RR 2.308), alcoholism, smoking abuse and drug addiction of parents (RR 2.000), and in our study the social factor of “disorganization” of the child was often present (RR 2,000). Considering somatic diseases that can act as risk factors for the development of an active tuberculosis process, we came to the following results: helminthic infestation (RR 3,000), iron deficiency anemia (RR 1,900), endocrinological pathology and metabolic disorders (RR 1,200), myopia (RR 1,429), gastritis and colitis (RR 2.286), rheumatism and osteomyelitis (RR 2.000), pyelonephritis (RR 1.333), kidney hydronephrosis (RR 3.000). It should be noted that the pathological conditions listed above also acted as predisposing factors to latent tuberculosis infection. However, in this group, we additionally established the significance of such a factor as respiratory pathology (bronchial asthma, allergic rhinitis) (RR 0.500). Conclusions. In the Republic of Uzbekistan, it is relevant to continue research work in this direction to assess the prognostic significance of previously established ones, as well as to discover new, modern factors, in order to improve the tactics of managing children with latent tuberculosis infection and prevent its progression into an active process.