The measurement of household socio-economic position in tuberculosis prevalence surveys: a sensitivity analysis
DESIGN: Data were drawn from the TB prevalence survey conducted in Lusaka Province, Zambia, in 2005–2006. We compared TB socio-economic inequalities measured through an asset-based index (Index 0) using principal component analysis (PCA) with those observed using three alternative indices: Index 1 and Index 2 accounted respectively for the biases resulting from the inclusion of urban assets and food-related variables in Index 0. Index 3 was built using regression-based analysis instead of PCA to account for the effect of using a different assets weighting strategy.
RESULTS: Household socio-economic position (SEP) was significantly associated with prevalent TB, regardless of the index used; however, the magnitude of inequalities did vary across indices. A strong association was found for Index 2, suggesting that the exclusion of food-related variables did not reduce the extent of association between SEP and prevalent TB. The weakest association was found for Index 1, indicating that the exclusion of urban assets did not lead to higher extent of TB inequalities.
CONCLUSION: TB socio-economic inequalities seem to be robust to the choice of SEP indicator. The epidemiological meaning of the different extent of TB inequalities is unclear. Further studies are needed to confirm our conclusions.
Keywords: inequalities; measurement; prevalence survey; socio-economic position; tuberculosis
Document Type: Research Article
Affiliations: 1: Faculty of Epidemiology and Population Health, Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK 2: Medical Research Council Centre for Causal Analyses in Translational Epidemiology, School of Social and Community Medicine, University of Bristol, Bristol, UK 3: Faculty of Epidemiology and Population Health, Department of Medical Statistics, London School of Hygiene & Tropical Medicine, London, UK 4: Faculty of Infectious and Tropical Diseases, Department of Clinical Research, London School of Hygiene & Tropical Medicine, London, UK; Zambia AIDS-Related TB Project, Ridgway Campus, University of Zambia, Lusaka, Zambia 5: Faculty of Infectious and Tropical Diseases, Department of Clinical Research, London School of Hygiene & Tropical Medicine, London, UK
Publication date: 01 January 2013
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