Medical and Social Risk Factors for Progression of Latent Tuberculosis Infection to Active Tuberculosis in Children Living in Household Contacts in Uzbekistan: A Prospective Study

Abstract

Introduction: Latent tuberculosis infection (LTBI) is characterized by a sustained immune response to Mycobacterium tuberculosis antigens without clinical, radiographic, or microbiological evidence of active disease. The aim of this study was to assess medical and social risk factors for progression of latent tuberculosis infection (LTBI) to active pulmonary tuberculosis in children with household TB contact. Materials and methods: A prospective study (2022–2024) involved 120 children aged 4–12 with LTBI. Two groups were formed: children who developed active TB (LTBI-to-TB group) and those who remained latent. Inclusion required consent. Clinical, immunological (IL-2, IgM), and social factors were analyzed. Risk was evaluated via relative risk (RR) and 95% confidence intervals. Results: Progression to active TB was linked to bacillary TB contact (RR=6.5), maternal TB (RR=5.2), anemia (RR=3.8), ≥5 ARI episodes/year (RR=26.0), ineffective BCG (RR=3.0), single-parent homes (RR=11.0), territorial TB (RR=4.5), helminthiasis (RR=10.0), chickenpox (RR=5.0), genitourinary diseases (RR=8.0), ENT pathology (RR=5.7), isoniazid monotherapy (RR=2.7), COVID-19 or HIV exposure (RR=8.0), IL-2 ≥311.1 ng/ml, and IgM ≥1.18 IU/ml. Discussions: Immunological and social factors increase LTBI progression risk. High-risk children need tailored monitoring.