Prevalence of latent tuberculosis infection and associated risk factors in an urban African setting
Prevalence of latent tuberculosis infection and associated risk factors in an urban African setting
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DOI：
10.1186/s12879-015-0904-1
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发表时间：
2015-03-29
影响因子：
3.7
通讯作者：
Sekandi, Juliet N.
中科院分区：
文献类型：
--
作者：
Kizza, Florence N.;List, Justin;Sekandi, Juliet N.
背景资料：世界上近三分之一的人感染了潜伏性结核病感染（LTBI），发展中国家仍有大量的LTBI患者，这对全球结核病控制构成了主要障碍。本研究的目的是确定LTBI的患病率和相关的危险因素成人在坎帕拉，Uganda.Methods：我们进行了二次分析，从门到门的横截面调查慢性咳嗽进行2008年1月至2009年6月。分析包括接受过结核菌素皮肤检测（TST）的坎帕拉Rubaga社区15岁及以上的城市居民。主要结局为LTBI，定义为TST伴10 mm或更大硬结。结果：共290名受试者接受了TST测试，283名受试者接受了TST测试，7名受试者在48-72小时内未能追踪到TST，因此未接受TST测试。在TST结果的参与者中，68%为女性，75%为15-34岁，83%至少接受过13年的教育，12%为吸烟者，50%目前已婚，57%离家上学或就业，21%为艾滋病毒阳性，65%报告慢性咳嗽2周或更长时间。LTBI的总体患病率为49% [95%CI 44-55]，存在一些年龄和性别特异性差异。多因素分析显示，离家上学或就业，aOR = 1.72; [95%CI：1.05，2.81]和年龄25-34，aOR = 1.94; [95%CI：1.12，3.38]; 35岁及以上，aOR = 3.12; [95%CI：1.65，5.88]是LTBI的显著危险因素。在非洲城市环境中，LTBI的患病率很高。在这种情况下，离家上学或就业以及年龄较大是与LTBI显著相关的因素。这表明一个人在家庭之外的社会网络的扩展和随着年龄的增长暴露于结核病的累积风险在获得LTBI中的潜在作用。我们的研究结果为这些亚组的LTBI筛查和预防性治疗提供了支持，以加强结核病控制。
Background: Nearly one third of the world is infected with latent tuberculosis infection (LTBI) and a vast pool of individuals with LTBI persists in developing countries, posing a major barrier to global TB control. The aim of the present study was to determine the prevalence of LTBI and the associated risk factors among adults in Kampala, Uganda.Methods: We performed a secondary analysis from a door-to-door cross-sectional survey of chronic cough conducted from January 2008 to June 2009. Urban residents of Rubaga community in Kampala aged 15 years and older who had received Tuberculin skin testing (TST) were included in the analysis. The primary outcome was LTBI defined as a TST with induration 10 mm or greater. Multivariable logistic regression analyses were used to assess the risk factors associated with LTBI.Results: A total of 290 participants were tested with TST, 283 had their tests read and 7 didn't have the TST read because of failure to trace them within 48-72 hours. Of the participants with TST results, 68% were female, 75% were 15-34 years, 83% had attained at least 13 years of education, 12% were smokers, 50% were currently married, 57% left home for school or employment, 21% were HIV positive and 65% reported chronic cough of 2 weeks or longer. The overall prevalence of LTBI was 49% [95% CI 44-55] with some age-and sex-specific differences. On multivariable analysis, leaving home for school or employment, aOR = 1.72; [95% CI: 1.05, 2.81] and age 25-34, aOR = 1.94; [95% CI: 1.12, 3.38]; 35 years and older, aOR = 3.12; [95% CI: 1.65, 5.88] were significant risk factors of LTBI.Conclusion: The prevalence of LTBI was high in this urban African setting. Leaving home for school or employment and older age were factors significantly associated with LTBI in this setting. This suggests a potential role of expansion of one's social network outside the home and cumulative risk of exposure to TB with age in the acquisition of LTBI. Our results provide support for LTBI screening and preventive treatment programs of these sub-groups in order to enhance TB control.