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

Khan, PY; Glynn, JR; Fielding, KL; Mzembe, T; Mulawa, D; Chiumya, R; Fine, PEM; Koole, O; Kranzer, K; Crampin, AC; (2016) Risk factors for Mycobacterium tuberculosis infection in 2-4 year olds in a rural HIV-prevalent setting. The international journal of tuberculosis and lung disease, 20 (3). pp. 342-349. ISSN 1027-3719 DOI: https://doi.org/10.5588/ijtld.15.0672

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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: Article
Faculty and Department: Faculty of Epidemiology and Population Health > Dept of Infectious Disease Epidemiology
Faculty of Infectious and Tropical Diseases > Dept of Clinical Research
Research Centre: MEIRU
TB Centre
PubMed ID: 27046715
Web of Science ID: 371192300013
URI: http://researchonline.lshtm.ac.uk/id/eprint/2535733


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