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Risk factors for Mycobacterium tuberculosis infection in 2-4 year olds in a rural HIV-prevalent setting

P Y Khan1, J R Glynn2, K L Fielding2

  • 1Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, Keppel Street, London WD1E 7HT, UK; Karonga Prevention Study, Chilumba, Malawi. palwasha.khan@lshtm.ac.uk.

The International Journal of Tuberculosis and Lung Disease : the Official Journal of the International Union Against Tuberculosis and Lung Disease
|April 6, 2016
PubMed

Insights

Tuberculosis infection in young children is a key indicator of community disease spread. This study identified maternal HIV and household size as risk factors, but most infections remained unexplained.

Area of Science:

  • Pediatric infectious diseases
  • Public health epidemiology
  • Tuberculosis research

Background:

  • Tuberculosis (TB) infection in children serves as an early indicator of infectious TB within a community.
  • Understanding pediatric TB is crucial for effective public health surveillance and control strategies.

Purpose of the Study:

  • To identify and assess the risk factors associated with tuberculous infection in preschool-aged children.
  • To evaluate the prevalence of Mycobacterium tuberculosis infection in a defined pediatric population.

Main Methods:

  • A population-wide tuberculin skin test (TST) survey was conducted in Malawi from January to December 2012.
  • Data included demographic information, maternal human immunodeficiency virus (HIV) status, and clinical/sociodemographic data of diagnosed TB patients.
  • Children aged 2-4 years within a demographic surveillance area were eligible for the study.

Main Results:

  • The prevalence of Mycobacterium tuberculosis infection was 1.1%, with an estimated annual risk of infection of 0.3%.
  • Identified risk factors included maternal HIV infection at birth (aOR 3.6), households with three or more adults (aOR 2.4), and proximity to infectious TB cases (aOR 1.6).
  • A significant portion of infected children did not live in close proximity to a known diagnosed TB case.

Conclusions:

  • The study highlights maternal HIV and household factors as significant risks for pediatric TB infection.
  • However, identified household and community risk factors do not account for the majority of Mycobacterium tuberculosis infections observed in children.
  • Further research is needed to elucidate the remaining transmission pathways and risk factors for pediatric TB.
Abstract

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