Modifiable risk factors associated with tuberculosis disease in children in Pune, India

作者：Jubulis J^*; Kinikar A; Ithape M; Khandave M; Dixit S; Hotalkar S; Kulkarni V; Mave V; Gupte N; Kagal A; Jain S; Bharadwaj R; Gupta A

来源：International Journal of Tuberculosis and Lung Disease, 2014, 18(2): 198-204.

DOI：10.5588/ijtld.13.0314

• pediatric tuberculosis
• household food insecurity
• indoor air pollution
• vitamin D deficiency

SETTING: India accounts for the largest burden of tuberculosis (TB) worldwide, with 26% of the world's cases.
OBJECTIVE: To assess the association between novel modifiable risk factors and TB in Indian children.
DESIGN: Cases were children aged <= 5 years with confirmed/probable TB based on World Health Organization definitions (definition 1). Controls were healthy children aged <= 5 years. Logistic regression was performed to estimate the adjusted odds ratio (aOR) of being a TB case given exposure, including indoor air pollution (LAP; exposure to tobacco smoke and/or biomass fuels) and vitamin D deficiency. Cases were re-analyzed according to a new consensus research definition of pediatric TB (definition 2).
RESULTS: Sixty cases and 118 controls were enrolled. Both groups had high levels of vitamin D deficiency (55% vs. 50%, P = 0.53). In multivariable analysis, TB was associated with household TB exposure (aOR 25.41, 95%CI 7.03-91.81), household food insecurity (aOR 11.55, 95%CI 3.33-40.15) and TAP exposure (aOR 2.67, 95%CI 1.02-6.97), but not vitamin D deficiency (aOR 1.00, 95%CI 0.38-2.66). Use of definition 2 reduced the number of cases to 25. In multivariate analysis, TB exposure, household food insecurity and TAP remained associated with TB.
CONCLUSIONS: Household TB exposure, exposure to TAP and household food insecurity were independently associated with pediatric TB.

• 出版日期2014-2