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Risk factors of childhood tuberculosis: a case control study from rural Bangladesh
Mohamed R Karim1, Mohamed A Rahman1, Shaikh Aa Mamun2
1National Institute of Preventive and Social Medicine, Dhaka, Bangladesh.
Insights
Childhood tuberculosis (TB) risk factors were explored in Bangladesh. Lower risk was associated with younger age, education, father's employment, less crowded rooms, separate kitchens, and distant TB case contact.
Area of Science:
- Public Health
- Epidemiology
- Pediatrics
Background:
- Childhood tuberculosis (TB) remains a significant global health challenge, contributing to childhood morbidity and mortality.
- Despite its impact, childhood TB is often a neglected disease, necessitating further research into its risk factors.
Purpose of the Study:
- To investigate the risk factors associated with childhood tuberculosis (TB).
- To identify predictors of smear-positive TB in children under 18 years of age.
Main Methods:
- A case-control study was conducted in Bangladesh from January to May 2011.
- Ninety-five sputum-positive childhood TB cases were compared with 94 sputum-negative controls.
- Data were collected using structured questionnaires, and statistical analysis included logistic regression to identify independent predictors.
Main Results:
- Factors associated with a lower likelihood of childhood TB included younger age (<14 years), primary education completion, fathers in business or service occupations, less crowded sleeping arrangements, and living in houses with separate kitchens.
- Contact with TB cases among relatives or neighbors showed a lower association with TB compared to contact within the family.
Conclusions:
- Age, parental education, father's occupation, household crowding, kitchen location, and the nature of contact with tuberculosis cases are significant factors associated with childhood TB.
- These findings highlight the importance of socioeconomic and environmental factors in childhood TB transmission and prevention.
Background:
Childhood tuberculosis (TB) is one of the major causes of childhood morbidity and mortality; however, it is relatively a neglected disease. Hence, we explored the risk factors for childhood TB.
Methods:
Ninty-five cases and 94 controls were selected during January to May 2011 from DOTS centres located in four sub-districts of Bangladesh. The exposure status of recently diagnosed childhood TB patients (<18-year-olds), who were sputum-positive, were compared with children who were sent to the laboratory with suspected tuberculosis but were found to be sputum-negative. Data were collected by a structured questionnaire. Crude odds ratios (OR), adjusted odds ratio (AOR) and 95% confidence intervals (CI) were estimated. Stepwise logistic regression model was used to identify independent predictors.
Results:
Children under 14 years of age (AOR: 0.25; 95% CI: 0.10-0.66), having completed primary education (AOR: 0.28; 95% CI: 0.10-0.74), whose fathers' were in business or service (AOR: 0.24; 95% CI: 0.08-0.72), and who slept in a less crowded room (AOR: 0.32; 95% CI: 0.14-0.76), lived in a house with a separate kitchen (AOR: 0.39; 95% CI: 0.16-0.96) had less chance of having TB. Those who had contact with cases of TB among relatives or neighbours were less likely to have TB (AOR: 0.28; 95% CI: 0.16-0.70) compared to those who had contact with a TB case in the family.
Conclusion:
Age, education, father's occupation, crowding, kitchen location and intimate contact with a TB case were significantly associated with smear-positive childhood TB.
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