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