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The age-specific burden and household and school-based predictors of child and adolescent tuberculosis infection in rural Uganda

BACKGROUND: The age-specific epidemiology of child and adolescent tuberculosis (TB) is poorly understood, especially in rural areas of East Africa. We sought to characterize the age-specific prevalence and predictors of TB infection among children and adolescents living in rural Uganda, and to explo...

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Autores principales: Marquez, Carina, Atukunda, Mucunguzi, Balzer, Laura B., Chamie, Gabriel, Kironde, Joel, Ssemmondo, Emmanuel, Ruel, Theodore D., Mwangwa, Florence, Tram, Khai Hoan, Clark, Tamara D., Kwarisiima, Dalsone, Petersen, Maya, Kamya, Moses R., Charlebois, Edwin D., Havlir, Diane V.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6988961/
https://www.ncbi.nlm.nih.gov/pubmed/31995631
http://dx.doi.org/10.1371/journal.pone.0228102
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author Marquez, Carina
Atukunda, Mucunguzi
Balzer, Laura B.
Chamie, Gabriel
Kironde, Joel
Ssemmondo, Emmanuel
Ruel, Theodore D.
Mwangwa, Florence
Tram, Khai Hoan
Clark, Tamara D.
Kwarisiima, Dalsone
Petersen, Maya
Kamya, Moses R.
Charlebois, Edwin D.
Havlir, Diane V.
author_facet Marquez, Carina
Atukunda, Mucunguzi
Balzer, Laura B.
Chamie, Gabriel
Kironde, Joel
Ssemmondo, Emmanuel
Ruel, Theodore D.
Mwangwa, Florence
Tram, Khai Hoan
Clark, Tamara D.
Kwarisiima, Dalsone
Petersen, Maya
Kamya, Moses R.
Charlebois, Edwin D.
Havlir, Diane V.
author_sort Marquez, Carina
collection PubMed
description BACKGROUND: The age-specific epidemiology of child and adolescent tuberculosis (TB) is poorly understood, especially in rural areas of East Africa. We sought to characterize the age-specific prevalence and predictors of TB infection among children and adolescents living in rural Uganda, and to explore the contribution of household TB exposure on TB infection. METHODS: From 2015–2016 we placed and read 3,121 tuberculin skin tests (TST) in children (5–11 years old) and adolescents (12–19 years old) participating in a nested household survey in 9 rural Eastern Ugandan communities. TB infection was defined as a positive TST (induration ≥10mm or ≥5mm if living with HIV). Age-specific prevalence was estimated using inverse probability weighting to adjust for incomplete measurement. Generalized estimating equations were used to assess the association between TB infection and multi-level predictors. RESULTS: The adjusted prevalence of TB infection was 8.5% (95%CI: 6.9–10.4) in children and 16.7% (95% CI:14.0–19.7) in adolescents. Nine percent of children and adolescents with a prevalent TB infection had a household TB contact. Among children, having a household TB contact was strongly associated with TB infection (aOR 5.5, 95% CI: 1.7–16.9), but the strength of this association declined among adolescents and did not meet significance (aOR 2.3, 95% CI: 0.8–7.0). The population attributable faction of TB infection due to a household TB contact was 8% for children and 4% among adolescents. Mobile children and adolescents who travel outside of their community for school had a 1.7 (95% CI 1.0–2.9) fold higher odds of TB infection than those who attended school in the community. CONCLUSION: Children and adolescents in this area of rural eastern Uganda suffer a significant burden of TB. The majority of TB infections are not explained by a known household TB contact. Our findings underscore the need for community-based TB prevention interventions, especially among mobile youth.
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spelling pubmed-69889612020-02-04 The age-specific burden and household and school-based predictors of child and adolescent tuberculosis infection in rural Uganda Marquez, Carina Atukunda, Mucunguzi Balzer, Laura B. Chamie, Gabriel Kironde, Joel Ssemmondo, Emmanuel Ruel, Theodore D. Mwangwa, Florence Tram, Khai Hoan Clark, Tamara D. Kwarisiima, Dalsone Petersen, Maya Kamya, Moses R. Charlebois, Edwin D. Havlir, Diane V. PLoS One Research Article BACKGROUND: The age-specific epidemiology of child and adolescent tuberculosis (TB) is poorly understood, especially in rural areas of East Africa. We sought to characterize the age-specific prevalence and predictors of TB infection among children and adolescents living in rural Uganda, and to explore the contribution of household TB exposure on TB infection. METHODS: From 2015–2016 we placed and read 3,121 tuberculin skin tests (TST) in children (5–11 years old) and adolescents (12–19 years old) participating in a nested household survey in 9 rural Eastern Ugandan communities. TB infection was defined as a positive TST (induration ≥10mm or ≥5mm if living with HIV). Age-specific prevalence was estimated using inverse probability weighting to adjust for incomplete measurement. Generalized estimating equations were used to assess the association between TB infection and multi-level predictors. RESULTS: The adjusted prevalence of TB infection was 8.5% (95%CI: 6.9–10.4) in children and 16.7% (95% CI:14.0–19.7) in adolescents. Nine percent of children and adolescents with a prevalent TB infection had a household TB contact. Among children, having a household TB contact was strongly associated with TB infection (aOR 5.5, 95% CI: 1.7–16.9), but the strength of this association declined among adolescents and did not meet significance (aOR 2.3, 95% CI: 0.8–7.0). The population attributable faction of TB infection due to a household TB contact was 8% for children and 4% among adolescents. Mobile children and adolescents who travel outside of their community for school had a 1.7 (95% CI 1.0–2.9) fold higher odds of TB infection than those who attended school in the community. CONCLUSION: Children and adolescents in this area of rural eastern Uganda suffer a significant burden of TB. The majority of TB infections are not explained by a known household TB contact. Our findings underscore the need for community-based TB prevention interventions, especially among mobile youth. Public Library of Science 2020-01-29 /pmc/articles/PMC6988961/ /pubmed/31995631 http://dx.doi.org/10.1371/journal.pone.0228102 Text en © 2020 Marquez et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Marquez, Carina
Atukunda, Mucunguzi
Balzer, Laura B.
Chamie, Gabriel
Kironde, Joel
Ssemmondo, Emmanuel
Ruel, Theodore D.
Mwangwa, Florence
Tram, Khai Hoan
Clark, Tamara D.
Kwarisiima, Dalsone
Petersen, Maya
Kamya, Moses R.
Charlebois, Edwin D.
Havlir, Diane V.
The age-specific burden and household and school-based predictors of child and adolescent tuberculosis infection in rural Uganda
title The age-specific burden and household and school-based predictors of child and adolescent tuberculosis infection in rural Uganda
title_full The age-specific burden and household and school-based predictors of child and adolescent tuberculosis infection in rural Uganda
title_fullStr The age-specific burden and household and school-based predictors of child and adolescent tuberculosis infection in rural Uganda
title_full_unstemmed The age-specific burden and household and school-based predictors of child and adolescent tuberculosis infection in rural Uganda
title_short The age-specific burden and household and school-based predictors of child and adolescent tuberculosis infection in rural Uganda
title_sort age-specific burden and household and school-based predictors of child and adolescent tuberculosis infection in rural uganda
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6988961/
https://www.ncbi.nlm.nih.gov/pubmed/31995631
http://dx.doi.org/10.1371/journal.pone.0228102
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