Tuberculosis: associations with HIV and socioeconomic status in rural Malawi

Glynn, J.R., Warndorff, D.K., Malema, S.S., Mwinuka, V., Pönnighaus, J.M., Crampin, A.C. and Fine, P.E.M. (2000) Tuberculosis: associations with HIV and socioeconomic status in rural Malawi. Transactions of the Royal Society of Tropical Medicine and Hygiene, 94(5), pp. 500-503. (doi: 10.1016/s0035-9203(00)90065-8) (PMID:11132374)

Abstract

Tuberculosis (TB) is associated with human immunodeficiency virus (HIV) infection, increasing age and male sex, but less is known about other risk factors in developing countries. As part of the Karonga Prevention Study in northern Malawi, we conducted a retrospective cohort study in the general population to assess risk factors for the development of TB. Individuals were identified in 1986–1989 and TB cases diagnosed up to 1996 were included. TB was confirmed in 62/11059 (0·56%) HIV negative individuals and 7/182 (3·9%) HIV positive individuals (relative risk 7·1, 95% confidence interval 3·2–15·7). This association was little altered by adjustment for age, sex or socioeconomic factors. The risk of TB was higher in those aged over 30 years than in younger individuals, in men than in women, in those engaged in occupations other than farming than in subsistence farmers, in those living in households with burnt brick dwellings than in those with less well built dwellings, and in those with some schooling than in those with none. These associations persisted after adjusting for age, sex, HIV status and population density. The absolute risks of TB were low in this study due to the passive follow-up and strict diagnostic criteria. The relative risk with HIV was of a similar magnitude to that measured elsewhere. Increased risks of TB with age and in men are expected. Associations with measures of higher socioecomomic status were unexpected. They may reflect a greater likelihood of diagnosis in this group.

• Item Type: Articles
• Additional Information: Until 1996 the Karonga Prevention Study was funded primarily by LEPRA (the British Leprosy Relief Association) and ILEP (the International Federation of Anti-Leprosy Organizations) with contributions from the WHO/UNDP/World Bank Special Programme for Research and Training in Tropical Diseases. Since 1996 the Wellcome Trust has been the principal funder. J. R. G. is supported by the British Department for International Development.
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Crampin, Professor Mia
• Authors: Glynn, J.R., Warndorff, D.K., Malema, S.S., Mwinuka, V., Pönnighaus, J.M., Crampin, A.C., and Fine, P.E.M.
• College/School: College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Public Health
• Journal Name: Transactions of the Royal Society of Tropical Medicine and Hygiene
• Publisher: Oxford University Press
• ISSN: 0035-9203
• ISSN (Online): 1878-3503