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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...
Autores principales: | , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2020
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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. |
format | Online Article Text |
id | pubmed-6988961 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
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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