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Risk factors for Mycobacterium tuberculosis infection in 2–4 year olds in a rural HIV-prevalent setting
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.
Keywords: HIV; M. tuberculosis infection; children; community; household; risk factors
Document Type: Research Article
Affiliations: 1: Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, Keppel Street, London WD1E 7HT, UK; Karonga Prevention Study, Chilumba, Malawi. [email protected] 2: Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK 3: Karonga Prevention Study, Chilumba, Malawi 4: Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK; Karonga Prevention Study, Chilumba, Malawi 5: National and Supranational Mycobacterium Reference Laboratory, Forschungszentrum Borstel, Borstel, Germany
Publication date: 01 March 2016
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