ANALYSIS OF RISK FACTORS FOR THE TRANSFER OF LATENT TUBERCULOSIS INFECTION TO ACTIVE TUBERCULOSIS IN CHILDREN LIVING IN FAMILY TUBERCULOSIS FACTORIES

Abstract

Relevance. According to the WHO definition, latent tuberculosis infection (LTBI) represents a state of persistence of Mycobacterium tuberculosis in the absence of clinical manifestations of the disease, which can only be detected through immunological tests. Experts estimate that about one-quarter of the world’s population is infected with LTBI, with a lifetime risk of reactivation ranging from 5% to 15%, particularly within the first five years after infection and predominantly during childhood. Within the framework of the global tuberculosis control strategy after 2015, special attention has been directed to the early detection and prevention of LTBI as a key element in reducing the incidence of new cases. However, to date, no “gold standard” exists for diagnosing and differentiating latent and active forms of tuberculosis in children. Objective. To study the anamnestic and social indicators of latent tuberculosis infection development and active tuberculosis course in children. Materials and Methods. A retrospective-prospective cohort study was conducted in accordance with the international STROBE standard. A total of 60 children were included and divided into two groups: Group 1 consisted of 40 children with latent tuberculosis infection, and Group 2 included 20 children with active tuberculosis. Results. It was established that the key social risk factors for tuberculosis activation were living in low-income, large, and single-parent families, poor housing conditions, low parental education, unemployment, and harmful habits. Among biological factors, low birth weight, perinatal CNS lesions, early childhood anemia, as well as concomitant chronic conditions (helminthic invasions, gastrointestinal and endocrine disorders, myopia, rheumatism) were identified. Epidemiological factors included contact with bacillary patients, lack of chemoprophylaxis, non-compliance with sanitary measures in households, living in families with HIV infection, and a history of COVID-19. Conclusions. Thus, the study confirmed the multifactorial nature of the risk of LTBI activation in children, where social, biological, and epidemiological components play a significant role. The authors emphasize the necessity of a comprehensive assessment of risk factors and their justified differentiation for latent and active tuberculosis forms, which has practical significance for prevention, early diagnosis, and rational monitoring of children in risk groups.