Prevalence and determinants of TB infection in a rural population in northeastern Myanmar

Tuberculosis (TB) is a major human threat, as evidenced by the large numbers of cases and deaths, particularly in developing countries with poor economic and educational statuses. Myanmar has one of the highest TB burdens in the world, but no TB information is available for people living in the rural northeastern regions of Myanmar. The present study estimated the prevalence of TB and identified factors associated with TB infection in people living in rural communities in Shan State.

A cross-sectional study was performed to gather information from participants. People aged 18-59 years who lived in the three areas with the highest numbers of TB cases in Shan State in northeastern Myanmar were included in the study population. A simple random method was used to select the sample from the villages. A validated questionnaire was used for data collection in face-to-face interviews after obtaining signed informed consent from the selected participants. The Mantoux tuberculin skin test (TST) was administered to detect TB infection, and a result that was 10 mm or greater after 48 h was considered positive. Chi-squared tests and logistic regression were used to identify the associations between the variables at a significance level of α = 0.05.

A total of 303 participants were recruited for the study; 64.7% were females, and the mean age was 37 years (SD = 12.5). Most participants were Burmese (25.4%), and 14.95% were Shan. Sixty-three participants (20.8%) had a positive TST. Four variables were associated with TB infection in the multivariate model. Males had a greater chance of TB infection than females (AOR = 2.51; 95% CI = 1.32-4.76). Participants who were ever married had a greater chance of TB infection than participants who were single (AOR = 3.93; 95% CI = 1.18-13.00). Participants who used wood and charcoal as their main sources of energy for cooking had a greater chance of TB infection than participants who used electricity (AOR = 4.23; 95% CI = 1.25-9.64). Participants who had a low level of TB prevention and care knowledge had a greater chance of TB infection than participants with a high level of TB prevention and care knowledge (AOR = 4.49; 95% CI = 1.88-10.72).

Public health programs that focus on improving knowledge of TB prevention and care and avoiding the use of wood and charcoal as the primary sources of energy for cooking, particularly in males and ever-married individuals, are urgently needed.