儿童反复上下呼吸道感染：结核病和艾滋病毒合并感染的预测价值评估

Acta Biomedica Scientifica Pub Date : 2024-06-01 DOI:10.29413/abs.2024-9.2.21

S. Shugaeva, L. P. Pashkova, E. I. Vasilyeva, S. Zvonkova, O. G. Koshkina, O. Ogarkov

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摘要

背景。在咽喉病学中，所有反复呼吸道感染都被视为儿童结核病（TB）的危险因素。对反复上呼吸道感染和下呼吸道感染的预测价值进行有区别的评估将提高选择性肺结核筛查的有效性。对结核病合并艾滋病病毒感染儿童反复上呼吸道和下呼吸道感染的预测价值进行差异化评估。我们对 249 名儿童反复呼吸道感染的国内流行率进行了回顾性研究（2010-2020 年），分为 4 组：72 名健康儿童（HC）；TB - 65 名结核病儿童；TB/HIV - 56 名艾滋病相关结核病儿童；HIV - 65 名艾滋病病毒感染儿童。在结核病组 15 名儿童（23%）和艾滋病毒感染组 3 名儿童（4%）的病历中发现了反复下呼吸道感染（P < 0.001；几率比（OR）- 8.6）。下呼吸道感染最常见于患肺结核病前一年（15 例中有 11 例），15 例中有 4 例是在纳入研究前 2 年内（p = 0.027；OR = 11.0）。在肺结核/艾滋病毒组中，与艾滋病毒组相比，下呼吸道感染的发病率仅在肺结核发生前一年确定--33 例中有 24 例（73%），而在艾滋病毒组中，34 例中有 10 例（29%）（χ2 = 10.9；p = 0.001；OR = 6.4）。HC组-TB组和HIV组-TB/HIV组的上呼吸道感染发生率无统计学差异。无论是否感染艾滋病毒，儿童患结核病的预测因素都是在患结核病前一年反复发生的下呼吸道感染。上呼吸道反复感染并不影响儿童结核病的发生，无论其是否感染艾滋病毒。

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Recurrent upper and lower respiratory tract infections in children: Assessment of predictive value in tuberculosis and HIV coinfection

Background. In phthisiology, all recurrent respiratory tract infections are considered risk factors for tuberculosis (TB) in children. A differentiated assessment of the predictive value of recurrent upper and lower respiratory tract infections will improve the effectiveness of selective TB screening.The aim. To carry out a differentiated assessment of the predictive value of recurrent upper and lower respiratory tract infections in children with tuberculosis and HIV coinfection.Materials and methods. We conducted a retrospective study (2010–2020) of the anamnestic prevalence of recurrent respiratory tract infections in 249 children divided into 4 groups: 72 healthy children (HC); TB – 65 children with tuberculosis; TB/HIV – 56 children with HIV-associated TB; HIV – 65 children with HIV infection.Results. Recurrent lower respiratory tract infections were detected in the anamnesis of 15 (23 %) children of the TB group and in 3 (4 %) children of the HC group (p < 0.001; odds ratio (OR) – 8.6). Lower respiratory tract infections were most common during the year preceding TB disease (11 out of 15 cases), within 2 years before the inclusion of children in the study – in 4 out of 15 cases (p = 0.027; OR = 11.0). In the TB/HIV group, the prevalence of lower respiratory tract infections compared to the HIV group was established only during the year preceding TB – 24 out of 33 cases (73 %) versus 10 out of 34 cases (29 %) in the HIV group (χ2 = 10.9; p = 0.001; OR = 6.4). The occurrence of upper respiratory tract infections in pairs of HC group – TB group and HIV group – TB/HIV group had no statistical differences.Conclusion. The predictor of TB in children regardless of their HIV status is the recurrent lower respiratory tract infections, registered during the year preceding the TB disease. The recurrent infections of the upper respiratory tract do not affect the realization of TB in children, regardless of their HIV status.

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Acta Biomedica Scientifica

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