期刊论文详细信息
BMC Infectious Diseases
Prevalence of latent tuberculosis infection and associated risk factors in an urban African setting
Juliet N Sekandi4  Christopher C Whalen3  Amara E Ezeamama3  Alphonse Okwera1  Allan K Nkwata3  Justin List2  Florence N Kizza3 
[1] National TB Treatment Center, School of Medicine, Makerere University, Mulago, Uganda;Department of Internal Medicine University of Michigan, Ann Arbor, MI, USA;Department of Epidemiology and Biostatistics, College of Public Health, University of Georgia, Athens, GA, USA;Makerere University School of Public Health, Kampala, Uganda
关键词: TB control;    Tuberculin skin testing;    Latent tuberculosis infection;   
Others  :  1173916
DOI  :  10.1186/s12879-015-0904-1
 received in 2014-10-06, accepted in 2015-03-13,  发布年份 2015
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【 摘 要 】

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.

【 授权许可】

   
2015 Kizza et al.; licensee BioMed Central.

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【 参考文献 】
  • [1]Hussain H, Akhtar S, Nanan D: Prevalence of and risk factors associated with Mycobacterium tuberculosis infection in prisoners, North West Frontier Province, Pakistan. Int J Epidemiol 2003, 32(5):794-9.
  • [2]Nkurunungi G, Lutangira JE, Lule SA, Akurut H, Kizindo R, Fitchett JR, et al.: Determining Mycobacterium tuberculosis infection among BCG-immunised Ugandan children by T-SPOT.TB and tuberculin skin testing. PLoS One 2012, 7(10):e47340.
  • [3]Mack U, Migliori GB, Sester M, Rieder HL, Ehlers S, Goletti D, et al.: LTBI: latent tuberculosis infection or lasting immune responses to M. tuberculosis? A TBNET consensus statement. Eur Respir J 2009, 33(5):956-73.
  • [4]Dye C, Scheele S, Dolin P, Pathania V, Raviglione MC: Consensus statement. Global burden of tuberculosis: estimated incidence, prevalence, and mortality by country. WHO Global Surveillance and Monitoring Project. JAMA 1999, 282(7):677-86.
  • [5]WHO. Global Tuberculosis Control, World Health Organization Report 2012. Geneva; 2013.WHO/HTM/TB/2012.6.
  • [6]Pai M, Joshi R, Dogra S, Mendiratta DK, Narang P, Dheda K, et al.: Persistently elevated T cell interferon-gamma responses after treatment for latent tuberculosis infection among health care workers in India: a preliminary report. J Occup Med Toxicol 2006, 1:7. BioMed Central Full Text
  • [7]Shakak AO, Khalil EAG, Musa AM, Salih KAEM, Bashir AEA, Ahmed AH, et al.: Prevalence of latent tuberculosis infection in Sudan: a case–control study comparing interferon-γ release assay and tuberculin skin test. BMC Public Health 2013, 13:1128. BioMed Central Full Text
  • [8]Whitaker JA, Mirtskhulava V, Kipiani M, Harris DA, Tabagari N, Kempker RR, et al.: Prevalence and incidence of latent tuberculosis infection in Georgian healthcare workers. PLoS ONE 2013, 8(3):8.
  • [9]Kayanja HK, Debanne S, King C, Whalen CC: Tuberculosis infection among health care workers in Kampala, Uganda. Int J Tuberc Lung Dis 2005, 9(6):686-8.
  • [10]Joshi R, Reingold AL, Menzies D, Pai M: Tuberculosis among health-care workers in Low- and middle-income countries: a systematic review. PLoS Med 2006, 3(12)):2376-91.
  • [11]Margolis B, Al-Darraji HAA, Wickersham JA, Kamarulzaman A, Altice FL: Prevalence of tuberculosis symptoms and latent tuberculous infection among prisoners in northeastern Malaysia. Int J Tuberc Lung Dis 2013, 17(12):1538-44.
  • [12]Rafiza S, Rampal KG, Tahir A: Prevalence and risk factors of latent tuberculosis infection among health care workers in Malaysia. BMC Infect Dis 2011, 11:19. BioMed Central Full Text
  • [13]Zhang X, Jia H, Liu F, Pan L, Xing A, Gu S, et al.: Prevalence and risk factors for latent tuberculosis infection among health care workers in China: a cross-sectional study. PLoS ONE 2013, 8(6):e66412-e.
  • [14]Hanifa Y, Grant AD, Lewis J, Corbett EL, Fielding K, Churchyard G: Prevalence of latent tuberculosis infection among gold miners in South Africa. Int J Tuberc Lung Dis 2009, 13(1):39-46.
  • [15]Legesse M, Ameni G, Mamo G, Medhin G, Bjune G, Abebe F: Community-based cross-sectional survey of latent tuberculosis infection in Afar pastoralists, Ethiopia, using QuantiFERON-TB Gold In-Tube and tuberculin skin test. BMC Infect Dis 2011, 11:89. BioMed Central Full Text
  • [16]Martinez L, Arman A, Haveman N, Lundgren A, Cabrera L, Evans CA, et al.: Changes in tuberculin skin test positivity over 20 years in periurban shantytowns in Lima, Peru. Am J Trop Med Hyg 2013, 89(3):507-15.
  • [17]Statistics: UBo. Uganda National Household Survey, 2009/10. UBOS, Kampala, Uganda; 2010.
  • [18]Sekandi JN, List J, Luzze H, Yin XP, Dobbin K, Corso PS, et al.: Yield of undetected tuberculosis and human immunodeficiency virus coinfection from active case finding in urban Uganda. Int J Tuberc Lung Dis 2014, 18(1):13-9.
  • [19]Centers for Disease Control and Prevention: Targeted Tuberculin Testing and Treatment of Latent Tuberculosis Infection MMWR 2000, 49(No.RR-6):1-71.
  • [20]Pelly TF, Santillan CF, Gilman RH, Cabrera LZ, Garcia E, Vidal C, et al.: Tuberculosis skin testing, anergy and protein malnutrition in Peru. Int J Tuberc Lung Dis 2005, 9(9):977-84.
  • [21]Shanaube K, Hargreaves J, Fielding K, Schaap A, Lawrence K-A, Hensen B, et al.: Risk factors associated with positive QuantiFERON-TB Gold In-Tube and tuberculin skin tests results in Zambia and South Africa. Plos One 2011, 6(4):e18206-e.
  • [22]Wood R, Liang H, Wu H, Middelkoop K, Oni T, Rangaka MX, et al.: Changing prevalence of tuberculosis infection with increasing age in high-burden townships in South Africa. Int J Tuberc Lung Dis 2010, 14(4):406-12.
  • [23]Cook VJ, Sun SJ, Tapia J, Muth SQ, Arguello DF, Lewis BL, et al.: Transmission network analysis in tuberculosis contact investigations. J Infect Dis 2007, 196(10):1517-27.
  • [24]Fitzpatrick LK, Hardacker JA, Heirendt W, Agerton T, Streicher A, Melnyk H, et al.: A preventable outbreak of tuberculosis investigated through an intricate social network. Clin Infect Dis 2001, 33(11):1801-6.
  • [25]Andre M, Ijaz K, Tillinghast JD, Krebs VE, Diem LA, Metchock B, et al.: Transmission network analysis to complement routine tuberculosis contact investigations. Am J Public Health 2007, 97(3):470-7.
  • [26]Klovdahl AS, Graviss EA, Yaganehdoost A, Ross MW, Wanger A, Adams GJ, et al.: Networks and tuberculosis: an undetected community outbreak involving public places. Soc Sci Med 2001, 52(5):681-94.
  • [27]Klovdahl AS, Potterat JJ, Woodhouse DE, Muth JB, Muth SQ, Darrow WW: Social networks and infectious disease: the Colorado Springs Study. Soc Sci Med 1994, 38(1):79-88.
  • [28]Whalen CC, Zalwango S, Chiunda A, Malone L, Eisenach K, Joloba M, et al.: Secondary attack rate of tuberculosis in urban households in Kampala, Uganda. PLoS One 2011, 6(2):e16137.
  • [29]Tornee S, Kaewkungwal J, Fungladda W, Silachamroon U, Akarasewi P, Sunakorn P: Risk factors for tuberculosis infection among household contacts in Bangkok, Thailand. Southeast Asian J Trop Med Public Health 2004, 35:375-83.
  • [30]Narain R, Nair S, Rao G, Chandrasekhar P: Distribution of tuberculous infection and disease among households in a rural community. Bull World Health Organ 1966, 34:639-54.
  • [31]Rieder HL: Contacts of tuberculosis patients in high-incidence countries. Int J Tuberc Lung Dis 2003, 7(12):S333-6.
  • [32]Morrison J, Pai M, Philip J, Hopewell C: Tuberculosis and latent tuberculosis infection in close contacts of people with pulmonary tuberculosis in low-income and middle-income countries: a systematic review and meta-analysis. Lancet Infect Dis 2008, 8:259-68.
  • [33]Madico G, Gilman RH, Cabrera L, Kacena K, Díaz JF, Gilman RH, et al.: Community infection ratio as an indicator for tuberculosis control. Lancet 1995, 345(8947):416-9.
  • [34]Nguyen T, Odermatt P, Slesak G, Barennes H: Risk of latent tuberculosis infection in children living in households with tuberculosis patients: a cross sectional survey in remote northern Lao People's Democratic Republic. BMC Infect Dis 2009, 9(1):96. BioMed Central Full Text
  • [35]Durando P, Sotgiu G, Spigno F, Piccinini M, Mazzarello G, Viscoli C, et al.: Latent tuberculosis infection and associated risk factors among undergraduate healthcare students in Italy: a cross-sectional study. BMC Infect Dis 2013, 13:443. doi: 10.1186/1471-2334-13-443 BioMed Central Full Text
  • [36]Parekh MJ, Schluger NW: Treatment of latent tuberculosis infection. Ther Adv Respir Dis 2013, 7(6):351-6.
  • [37]Churchyard GJ, Chaisson RE, Maartens G, Getahun H: Tuberculosis preventive therapy: An underutilised strategy to reduce individual risk of TB and contribute to TB control. S Afr Med J 2014, 104(5):339-43.
  • [38]Churchyard GJ, Mametja LD, Mvusi L, Ndjeka N, Hesseling AC, Reid A, et al.: Tuberculosis control in South Africa: successes, challenges and recommendations. S Afr Med J 2014, 104(3 Suppl 1):244-8.
  • [39]Dooley KE, Sterling TR: Treatment of latent tuberculosis infection: challenges and prospects. Clin Chest Med 2005, 26(2):313-26. vii
  • [40]Churchyard GJ, Fielding KL, Lewis JJ, Coetzee L, Corbett EL, Godfrey-Faussett P, et al.: A trial of mass isoniazid preventive therapy for tuberculosis control. N Engl J Med 2014, 370(4):301-10.
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