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Detailed analysis of risk factors in 161 children with pulmonary tuberculosis has established that tuberculosis risk-group children are ill in most cases (82.6%). Examining the results of annual tuberculin diagnosis in 2478 children aged 1 to 14 years in a children's city polyclinic could ascertain that the most risk groups comprise children with a conversion of tuberculin tests (5.2%) and tuberculosis-infected children with increased tuberculin sensitivity (7%) who are the basic contingent of followed up local district pediatric phthisiologists. The priorities of activities of pediatric phthisiology involve the detection of tuberculosis risk groups by the general pediatric service by the tuberculin diagnostic technique under the guidance of a phthisiological service and the choice of individual management policy by their pediatric phthisiologists.

The paper analyzes a contingent of children and adolescents from a tuberculous sanatorium in 2000-2002. It was established that the children and adolescents with local forms of tuberculosis amounted to 14.5%, the children with a variety of tuberculin reactions were 33.5%; the children infected with tuberculosis and risk factors were 42.1%; the total proportion of children who had contacted patients with tuberculosis was 31.7% of the whole contingent of the sanatorium, i.e. about a third. In addition to different manifestations of tuberculous infection, nonspecific abnormalities were detected in 96.4% of the children and adolescents, in the vast majority they being first diagnosed at the sanatorium. The foregoing suggests that a children's tuberculosis sanatorium is of great medical importance under the present conditions.

Examination of risk factors of infection and falling ill with tuberculosis in 453 adolescents who had different contacts with patients with tuberculosis (a study group) and 246 from the healthy environment (a control group) has ascertained that adolescents living in death foci fell ill with tuberculosis 6 times as frequent as the controls (18.2 versus 3.3%) and 3 times as frequent as other subgroups. A subgroup from bacterial isolation foci was the second severest epidemiological risk. They fell ill with tuberculosis twice as frequent as the persons having a contact with patients without bacterial isolates (8.0 and 4.1%) and 2.5 times as frequent as the controls (8.0 and 3.3%). In these subgroups of those fell ill with tuberculosis was slightly more than in the control group (4.1, 4.0, and 3.3%, respectively).

In the Kharkov Region, the rate of tuberculosis infection in children was 28.8%; among them children with a curve of tuberculin reactions was 3.8%; most of them had a moderate sensitivity to tuberculin. The remaining 71.2% of the examinees were not infected with tuberculosis; more than 50% of them (41.1%) had postvaccinal allergy.

Examining active tuberculosis in 38 infants has established the following features: the disease is characterized by predominantly (71%) classical forms of primary tuberculosis; moreover, a primary tuberculosis complex is more common (41.7%) than tuberculosis of intrathoracic lymph nodes (26.3%); by complicated tuberculosis in more than a third of the infants, by extrapulmonary tuberculosis in 23.7%, and by the affliction of 2 systems in 13.2%. Tuberculosis runs most severely in children under 1 year of age. The group at the highest risk for tuberculosis may include infants contacting patients with tuberculosis (65.8%), ill vaccinated infants with BCG (89.4%), infants with symptoms of intoxication and thoracic complaints (79.3%), and those with hyperergic and pronounced sensitivity to tuberculin.

Sixty-five children and adolescents with respiratory tuberculosis were examined to determine the proportion of cytomegalovirus infection among patients with tuberculosis and its impact on the occurrence and course of different forms of tuberculosis. The number of children and adolescents infected with cytomegalovirus among the patients with respiratory tuberculosis (66.2%) was found to be three times more than that among those not infected with tuberculosis (21.0). The absolute majority (91.3%) of the examinees with the complicated course of a tuberculous process were carriers of cytomegalovirus. They were found to have both antigens and antibodies to cytomegalovirus 9 times more frequently than patients with the smooth course of tuberculosis, which is indicative of the activity of cytomegalovirus infection. The findings suggest that cytomegalovirus infection has an impact on the occurrence and pattern of a tuberculous process.

Clinical and X-ray characteristics were studied in 102 children with first detected active respiratory tuberculosis. The patients with intrathoracic lymph nodal tuberculosis were 39.2%, those with a primary complex, tuberculosis pleurisy, disseminated tuberculosis, infiltrative tuberculosis, and focal tuberculosis, 33.3, 14.7, 4.9, 5.9, and 1.9%, respectively. Under the present conditions, respiratory tuberculosis is encountered more commonly (72.5%) in infants and pre-school children, which is characterized by its complicated course (30.4%), clinical symptomatology with signs of tuberculous intoxication (66.6%), hyperergic (29.4%) and pronounced (46.1%) tuberculin sensitivity. Surveys have revealed the disease in 58.8% of patients, by tuberculin diagnosis in 36.6 of them.

Variability of tuberculin reactions in adolescents may be represented by changes of a negative tuberculin test to a positive or false one, then to a positive test. Adolescents primarily infected with tuberculosis have predisposing factors: inadequate immunoprophylaxis contact with tuberculosis patients, discord in physical development, hyperergic sensitivity to tuberculin, which can determine a further course of tuberculosis infection. The variability of tuberculin reactions in adolescents is characterized by changed immunological responsiveness as higher immunospecific parameters and lower nonspecific responsiveness parameters, as well as decreased attention; there is a trend for frequent development of primary infection in persons having character accentuation. The aforesaid allows the variability of tuberculin reactions to be regarded as "minor disease".