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Area-Based Sociodemographic Factors Associated with Latent Tuberculosis Infection in a Low-Prevalence Setting
Jeffrey I Campbell1,2, Mary Tabatneck3, Grete E Wilt4
1Section of Pediatric Infectious Diseases, Boston Medical Center, Boston, Massachusetts.
The American Journal of Tropical Medicine and Hygiene
|August 14, 2023
Summary
Area-based poverty and the CDC
Area of Science:
- Epidemiology
- Public Health
- Pediatric Infectious Diseases
Background:
- Area-based sociodemographic markers are used to identify tuberculosis (TB) risk.
- These markers have not been evaluated as independent risk factors for pediatric TB infection.
Purpose of the Study:
- To evaluate associations between census tract poverty, crowding, foreign-born population, and the CDC's Social Vulnerability Index (CDC-SVI) ranking and TB infection in children.
- To assess the utility of area-based sociodemographic factors in characterizing pediatric TB infection risk in low-burden settings.
Main Methods:
- Retrospective analysis of children tested for TB infection in Boston, Massachusetts.
- Statistical evaluation of associations between census tract poverty, crowding, foreign-born population, CDC-SVI, and TB infection, with adjustments for age, crowding, foreign-born percentage, and preferred language.
Main Results:
- Increasing census tract poverty was associated with increased odds of TB infection (aOR per 10% increase: 1.20; P = 0.01), attenuated after language adjustment.
- Increasing CDC-SVI ranking was associated with increased odds of TB infection, even after adjustment for age and language preference (aOR per 10-point increase: 1.08; P = 0.01).
Conclusions:
- Area-based sociodemographic factors, including poverty and CDC-SVI, are valuable for characterizing pediatric TB infection risk.
- These factors help define the social ecology of pediatric TB infection in low-prevalence areas.
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