Nutritional Status and Tuberculosis Risk in Adult and Pediatric Household Contacts.


Aibana, O; Acharya, X; Huang, CC; Becerra, MC; Galea, JT; Chiang, SS; Contreras, C; Calderon, R; Yataco, R; Velásquez, GE; Tintaya, K; Jimenez, J; Lecca, L; Murray, MB; (2016) Nutritional Status and Tuberculosis Risk in Adult and Pediatric Household Contacts. PLoS One, 11 (11). e0166333. ISSN 1932-6203 DOI: 10.1371/journal.pone.0166333

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Abstract

Studies show obesity decreases risk of tuberculosis (TB) disease. There is limited evidence on whether high body mass index also protects against TB infection; how very high body mass indices influence TB risk; or whether nutritional status predicts this risk in children. We assessed the impact of body mass index on incident TB infection and disease among adults and children. We conducted a prospective cohort study among household contacts of pulmonary TB cases in Lima, Peru. We determined body mass index at baseline and followed participants for one year for TB infection and disease. We used Cox proportional regression analyses to estimate hazard ratios for incident TB infection and disease. We enrolled 14,044 household contacts, and among 6853 negative for TB infection and disease at baseline, 1787 (26.1%) became infected. A total of 406 contacts developed secondary TB disease during follow-up. Body mass index did not predict risk of TB infection but overweight household contacts had significantly decreased risk of TB disease (HR 0.48; 95% CI 0.37-0.64; p <0.001) compared to those with normal weight. Among adults, body mass index ≥ 35 kg/m2 continued to predict a lower risk of TB disease (HR 0.30; 95% CI 0.12-0.74; p 0.009). We found no association between high body mass index and TB infection or disease among children under 12 years of age. High body mass index protects adults against TB disease even at levels ≥ 35 kg/m2. This protective effect does not extend to TB infection and is not seen in children.

Item Type: Article
Faculty and Department: Faculty of Public Health and Policy > Dept of Social and Environmental Health Research
PubMed ID: 27835678
Web of Science ID: 387779200039
URI: http://researchonline.lshtm.ac.uk/id/eprint/3124910

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