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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