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Updated: May 4, 2026

The MODS method for diagnosis of tuberculosis and multidrug resistant tuberculosis
Published on: August 11, 2008
Modifiable risk factors associated with tuberculosis disease in children in Pune, India
Insights
Household TB exposure, food insecurity, and indoor air pollution (IAP) are linked to pediatric TB in India. Vitamin D deficiency was not found to be a significant risk factor in this study.
Area of Science:
- Public Health
- Pediatric Infectious Diseases
- Environmental Health
Background:
- India bears the world's largest tuberculosis (TB) burden, representing 26% of global cases.
- Understanding risk factors for pediatric TB is crucial for targeted interventions.
Purpose of the Study:
- To investigate the association between novel modifiable risk factors and TB in Indian children.
- To assess the role of indoor air pollution (IAP) and vitamin D deficiency in pediatric TB.
Main Methods:
- A case-control study involving children aged ≤ 5 years.
- Logistic regression was used to analyze associations with TB, including IAP and vitamin D deficiency.
- Two case definitions for pediatric TB were applied.
Main Results:
- Household TB exposure, food insecurity, and IAP were significantly associated with pediatric TB.
- Vitamin D deficiency was not found to be significantly associated with TB.
- Associations remained significant after applying a consensus research definition for pediatric TB.
Conclusions:
- Household TB exposure, IAP, and food insecurity are independent risk factors for pediatric TB in India.
- These findings highlight key modifiable factors for TB prevention strategies in children.
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 (IAP; 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 IAP 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 IAP remained associated with TB.
Conclusions:
Household TB exposure, exposure to IAP and household food insecurity were independently associated with pediatric TB.
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