Predictors of tuberculosis infection among children and adolescents with positive results of a skin test with recombinant TB allergen

Abstract

Introduction. In the context of a decrease in the tension of the epidemic situation on tuberculosis in Russia, it remains relevant to search for new ways to increase the effectiveness of preventive anti-tuberculosis measures among children and teenagers, taking into account an integrated approach to assessing all risk factors for tuberculosis in various age groups of the child population.Objective. Tо study the complex characteristics of groups at increased risk of tuberculosis among children of different ages who have positive results of a skin test with a recombinant tuberculous allergen (АТR).Materials and methods. The study retrospectively included 392 patients aged 2–17 years with a positive ATR test result. The рatients were randomized by age into 3 groups: in the 1st group there were 87 children 2–7 years old, in the 2nd group 182 children aged 8–14 years were included, in the 3rd group included 121 patients 15–17 years. The children did not have clinical and radiological signs of active tuberculosis and were HIV-negativ.Result. Among children and adolescents with a positive result of the test with ATR, social risk factors for developing tuberculosis (unfavorable living conditions, lack of permanent employment in 86.3% of parents) were determined. It was found that children living in families with low social status were dominated by contact with patients with multidrug resistance of the pathogen (MDR-TB), more than half of children (53.1%) had comorbidities. In 13.3% of children, small calcifications were detected in the lungs, in the intrathoracic lymph nodes.Conclusion. Among children 2–7 years old with positive results of the test with ATR, a complex of risk factors for the development of tuberculosis prevails: low material security in every second family, alcohol and drug dependence of parents in every third family, contact with MDR-TB patients in 56.5% of children, high incidence of concomitant pathology (in 67.4% of children).