Non-specific risk factors of early period of primary tuberculosis infection in children

Introduction. The influence of numerous non-specific factors has not been sufficiently studied. The lack of works in which the influence of a whole complex of factors was determined on the same group was the basis for this study. Study the features and values of the spectrum of nonspecific risk factors for the early period of primary tuberculosis (EPPT) in children at the present stage. Risk factors for the occurrence of EPPT in children can be conditionally divided into specific and non-specific. Factors characterizing the specifics of tuberculosis contact and BCG vaccination are classified as specific. All other factors that are related to the impact on the resistance of the child's body are considered non-specific.  Today, specific risk factors are well studied. Specialists have no doubt about the negative impact of tube contact and the absence or inefficient BCG vaccination or revaccination. In relation to non-specific risk factors, the role of microsocial factors has been determined to a greater extent: material standard of living, sanitary literacy and culture, and housing conditions. The effect of radionuclide contamination of residential areas on the course of tuberculosis in children was also revealed. Materials and methods. To study, nonspecific risk factors, an analysis of obstetric history data, the nature of the incidence of parents and ancestors, as well as child after birth, and microsocial data in 302 children aged 2 to 14 years. The survey was divided into two groups. The main group involves 198 children with availability EPPT, in the comparison group – 104 children without signs EPPT. Results and discussion. In the main group significantly more noted: obstetric history – complicated compression course (1,4 times; p<0,001), fetoplacental insufficiency (1,4 times; p<0,05), threat pregnancy termination (1,8 times; p<0,001), preeclampsia of the first half pregnancy (1,7 times; p<0,001), asphyxia at birth (4,1 times; p<0,001), complicated families (2,2 times; p<0,001); anamnesis short (up to 3 months) breastfeeding – nynaya (1,8 times; p<0,001), preenced chickenpox (2,1 times; p<0,001),  two or more childhood infections (2,1 times; p<0,001), transferred pneumonia (3,3 times; p<0,05) or bronchitis (2,7 times; p<0,001 ), chronic mother’s disease (1,6 times; p<0,05) or father (2,1 times; p<0,001), often ill with acute respiratory viral infections children (2,9 times; p<0,001). Frequency of concomitant pathology except for diseases of the nasopharynx, has not found reliable differences in groups (p >0, 05) were diagnosed among children of main, and otolaryngological diseases were 1,3 times more often (p<0,05) were diagnosed among children of the main group. But, if you compare the nature of dominance of frequency of concomitant pathology in groups by means of criteria signs then determined that by the most (nine utter from ten) diseases there were greater frequency in the main group (p < 0, 05) that it testifies to cumulative pathogenetic concomitant pathology. Among microsocial factors in the main group with respect to the group comparisons were significant more often noted: small (< 5 m2 per person) housing area (2,1 times; p<0,001), absence in the house which water (2,3 times; p<0,001), secondary education mother (1,8 times; p<0,001) and the father (1,9 times; p <0,001), insufficient (< 8 hours) sleep duration (1,7 times; p<0,05) and short-term (less than 2 hours per day) outdoor stay (p<0,001). Conclusions. Among the risk factors for the emergence EPPT the whole is involved a member of nonspecific factors such as genetic cargo on the part of the parents, the disappointing course of pregnancy and childbirth, transferred childhood infections, and the presence of a child of concomitant pathologic and unpleasant microsocial state. The beginning of the formation of risk factors EPPT falls for the period before the leading child (genetic cargo). Then in time measurement to him join perinatal factors, transferred childhood infections, concomitant pathology, and microsocial factors. The highest predictive significance revealed: complicated childbirth, mass birth of baby at birth, Living space and educational level of the mother.

Keywords. Early period of primary tuberculous infection, children, nonspecific risk factors.