Risk factors for Mycobacterium tuberculosis infection in 2–4 year olds in a rural HIV-prevalent setting

Khan, P.Y., Glynn, J.R., Fielding, K.L., Mzembe, T., Mulawa, D., Chiumya, R., Fine, P.E.M., Koole, O., Kranzer, K. and Crampin, A.C. (2016) Risk factors for Mycobacterium tuberculosis infection in 2–4 year olds in a rural HIV-prevalent setting. International Journal of Tuberculosis and Lung Disease, 20(3), pp. 342-349. (doi: 10.5588/ijtld.15.0672) (PMID:27046715) (PMCID:PMC4743681)

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Abstract

BACKGROUND: Mycobacterium tuberculosis infection in children acts as a sentinel for infectious tuberculosis. OBJECTIVE: To assess risk factors associated with tuberculous infection in pre-school children. METHOD: We conducted a population-wide tuberculin skin test (TST) survey from January to December 2012 in Malawi. All children aged 2–4 years residing in a demographic surveillance area were eligible. Detailed demographic data, including adult human immunodeficiency virus (HIV) status, and clinical and sociodemographic data on all diagnosed tuberculosis (TB) patients were available. RESULTS: The prevalence of M. tuberculosis infection was 1.1% using a TST induration cut-off of 15 mm (estimated annual risk of infection of 0.3%). The main identifiable risk factors were maternal HIV infection at birth (adjusted OR [aOR] 3.6, 95%CI 1.1–12.2), having three or more adult members in the household over a lifetime (aOR 2.4, 95%CI 1.2–4.8) and living in close proximity to a known case of infectious TB (aOR 1.6, 95%CI 1.1–2.4), modelled as a linear variable across categories (>200 m, 100–200 m, <100 m, within household). Less than 20% of the infected children lived within 200 m of a known diagnosed case. CONCLUSION: Household and community risk factors identified do not explain the majority of M. tuberculosis infections in children in our setting.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Crampin, Professor Mia
Authors: Khan, P.Y., Glynn, J.R., Fielding, K.L., Mzembe, T., Mulawa, D., Chiumya, R., Fine, P.E.M., Koole, O., Kranzer, K., and Crampin, A.C.
College/School:College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Public Health
Journal Name:International Journal of Tuberculosis and Lung Disease
Publisher:International Union Against Tuberculosis and Lung Disease
ISSN:1027-3719
ISSN (Online):1815-7920
Copyright Holders:Copyright © 2016 Khan et al.
First Published:First published in International Journal of Tuberculosis and Lung Disease 20(3):342-349
Publisher Policy:Reproduced under a Creative Commons License

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