Factores de riesgo médicos y sociales para la progresión de la infección tuberculosa latente a tuberculosis activa en niños en contacto intradomiciliario en Uzbekistán: un estudio prospectivo
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Introducción: La infección tuberculosa latente (ITBL) se caracteriza por una respuesta inmunitaria sostenida a antígenos de Mycobacterium tuberculosis sin evidencia clínica, radiográfica ni microbiológica de enfermedad activa. El objetivo de este estudio fue evaluar los factores de riesgo médicos y sociales para la progresión de la infección tuberculosa latente (ITBL) a tuberculosis pulmonar activa en niños con contacto domiciliario con TB. Materiales y métodos: Estudio prospectivo (2022-2024) en el que participaron 120 niños de 4 a 12 años con ITBL. Se formaron dos grupos: niños que desarrollaron tuberculosis activa (grupo ITBL a tuberculosis) y aquellos que permanecieron latentes. La inclusión requirió consentimiento informado. Se analizaron factores clínicos, inmunológicos (IL-2, IgM) y sociales. El riesgo se evaluó mediante el riesgo relativo (RR) y sus intervalos de confianza del 95%. Resultados: La progresión a TB activa se relacionó con el contacto con TB bacilar (RR = 6,5), TB materna (RR = 5,2), anemia (RR = 3,8), >5 episodios de IRA/año (RR = 26,0), BCG ineficaz (RR = 3,0), hogares monoparentales (RR = 11,0), TB territorial (RR = 4,5), helmintiasis (RR = 10,0), varicela (RR = 5,0), enfermedades genitourinarias (RR = 8,0), patología otorrinolaringológica (RR = 5,7), monoterapia con isoniazida (RR = 2,7), exposición a COVID-19 o VIH (RR = 8,0), IL-2 >311,1 ng/ ml e IgM >1,18 UI/ml. Discusión: Los factores inmunológicos y sociales aumentan el riesgo de progresión de la ITBL. Los niños de alto riesgo necesitan un seguimiento personalizado.
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