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Free Content Socio-economic status and risk of tuberculosis: a case-control study of HIV-infected patients in Asia

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SETTING: Tuberculosis (TB) is the most common human immunodeficiency virus (HIV) related opportunistic infection and cause of acquired immune-deficiency syndrome related death. TB often affects those from a low socio-economic background.

OBJECTIVE: To assess the socio-economic determinants of TB in HIV-infected patients in Asia.

DESIGN: This was a matched case-control study. HIV-positive, TB-positive cases were matched to HIV-positive, TB-negative controls according to age, sex and CD4 cell count. A socio-economic questionnaire comprising 23 questions, including education level, employment, housing and substance use, was distributed. Socio-economic risk factors for TB were analysed using conditional logistic regression analysis.

RESULTS: A total of 340 patients (170 matched pairs) were recruited, with 262 (77.1%) matched for all three criteria. Pulmonary TB was the predominant type (n = 115, 67.6%). The main risk factor for TB was not having a university level education (OR 4.45, 95%CI 1.50–13.17, P = 0.007). Burning wood or coal regularly inside the house and living in the same place of origin were weakly associated with TB diagnosis.

CONCLUSIONS: These data suggest that lower socio-economic status is associated with an increased risk of TB in Asia. Integrating clinical and socio-economic factors into HIV treatment may help in the prevention of opportunistic infections and disease progression.
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Keywords: HIV; TB; matched; questionnaire; socio-economic

Document Type: Research Article

Affiliations: 1: The Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia 2: Queen Elizabeth Hospital, Hong Kong, SAR China 3: National Hospital for Tropical Diseases, Hanoi, Viet Nam 4: Faculty of Medicine Udayana University & Sanglah Hospital, Bali, Indonesia 5: Bach Mai Hospital, Hanoi, Viet Nam 6: Research Institute for Tropical Medicine, Manila, The Philippines 7: Working Group on AIDS, Faculty of Medicine, University of Indonesia/Cipto Mangunkusumo Hospital, Jakarta, Indonesia 8: Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia 9: Beijing Ditan Hospital, Capital Medical University, Beijing, China 10: Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok 11: HIV-Netherlands Australia Thailand Research Collaboration, The Thai Red Cross AIDS Research Centre and Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand 12: Department of Infectious Diseases, Tan Tock Seng Hospital, Singapore, Singapore 13: Hospital Sungai Buloh, Sungai Buloh, Malaysia 14: Taipei Veterans General Hospital, Taipei, Taiwan 15: Therapeutics Research, Education, and AIDS Training in Asia, amfAR – The Foundation for AIDS Research, Bangkok, Thailand

Publication date: 01 February 2018

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  • The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.

    Certain IJTLD articles are selected for translation into French, Spanish, Chinese or Russian. They are available on the Union website

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