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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
Summary
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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