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Community infection ratio as an indicator for tuberculosis control

G Madico1, R H Gilman, W Checkley

  • 1AB Prisma, Lima, Peru.

Lancet (London, England)
|February 18, 1995
PubMed

Insights

Tuberculosis transmission in Peruvian shantytowns is often community-based, not just within households. This finding suggests current tuberculosis control strategies may need adaptation for high-transmission community settings.

Area of Science:

  • Epidemiology
  • Infectious Diseases
  • Public Health

Background:

  • Tuberculosis (TB) epidemiology requires further understanding, particularly transmission dynamics in vulnerable populations.
  • Investigating the balance between household and community spread is crucial for effective TB control.

Purpose of the Study:

  • To determine the relative importance of within-household versus community transmission of Mycobacterium tuberculosis in children.
  • To assess risk factors for TB infection in a Peruvian shantytown setting.

Main Methods:

  • A cross-sectional study involving 175 children from TB-infected households (contacts) and 382 children from uninfected households (controls).
  • Prevalence of Mycobacterium tuberculosis exposure was measured using the purified protein derivative (PPD) skin test.
  • The community infection ratio (CIR) was calculated to differentiate transmission sources.

Main Results:

  • 55% of contact children and 34% of control children tested PPD positive.
  • Living in a contact household and increasing age were significant risk factors for PPD positivity.
  • The adjusted odds ratio indicated a higher likelihood of community transmission in this setting compared to other studies.

Conclusions:

  • The study highlights significant community transmission of tuberculosis in the studied Peruvian shantytown.
  • Current TB control strategies, primarily focused on household contacts, may be insufficient for areas with high community transmission.
  • Tailored public health interventions are needed to address TB spread outside the household.

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