Tuberculosis risk factors in children with smear-positive tuberculosis adult as household contact

Abstract

Background Children in household contact of adults with smear-positive tuberculosis (TB) are at higher risk of TB infection. Screening of these children is a main strategy for eliminating childhood TB.Objective To determine risk factors of TB among children in household contact with smear-positive adult TB patients.Methods This case-control study was conducted in 5 public health centers at Batu Bara District, North Sumatera. We studied children from birth to 18 year-old living in the same house as adults with smear-positive TB. A tuberculosis scoring system was used to diagnosis TB in the children. Associations between risk factors and the incidence of TB were analyzed using Chi-square, Mann-Whitney U, and logistic regression tests.Results We enrolled 145 children who had household contact with smear-positive adult TB patients. Subjects were allocated to either the case group [TB score >6; 61 subjects (42.0%)] or the control group [TB score <6; 84 subjects (58.0%)]. Bivariate analysis revealed that nutritional status, immunization status, number of people in the house, sleeping in the same bed, and duration of household contact had significant associations with the incidence of TB. By multivariate logistic regression analysis, nutritional status and duration of household contact were significant risk factors for TB, with OR 5.89 and 8.91, respectively.Conclusion Malnutrition and duration of household contact with smear-positive adult TB patients of more than 6 hours per day were risk factors for TB among children.

Having Contact History With Tb Active Cases and Malnutrition as Risk Factors of Tb Incidence: A Cross-Sectional Study in North Sumatera, Indonesia

“…(15) This findings is consistent with previous studies that have demonstrated an association between having contact history with TB cases and the incidence of TB. (8,9,11,12,14,16) Malnutrition was another risk factor of TB infection. (2,(16)(17)(18) The association between malnutrition and TB incidence is bi-directional.…”

“…(8,9,11,12,14,16) Malnutrition was another risk factor of TB infection. (2,(16)(17)(18) The association between malnutrition and TB incidence is bi-directional. TB predisposes the patient to malnutrition and malnutrition increases the vulnerability of developing the disease.…”

“…(18,19) Epidemiological studies have shown that malnutrition affects genetic expression and impaired immune response, which are predisposing factors for tuberculosis progression. (2,16,18) Malnutrition is one of important risk factors for TB because it profoundly affects cell-mediated immunity (CMI). It is a condition when an immune response that does not involve antibodies; CMI also the principle host defense against TB.…”

“…It appears that although poor people have a higher risk of becoming infected, there is no direct evidence that the infected poor have a higher risk of developing disease. (2,5,16,21) In addition, another risk factors of TB incidence were physical conditions of house environment such as ventilation, lighting, occupancy density, humidity, temperature and type of floor. (22) Low socioeconomic status was related to not eligible of physical conditions of house environment.…”

Karakteristik Klinis Penyakit Tuberkulosis Paru pada Anak

“…Populasi padat menyebabkan interaksi yang intens dan durasi berkontak dengan penderita tuberkulosis semakin tinggi sehingga berpengaruh terhadan persebaran Mycobacterium tuberkulosis (Martinez et al, 2020;Donald et al, 2010). Hasil penelitian Hajarsyah dkk menyatakan bahwa, faktor risiko yang paling berpengaruh terhadap kejadian tuberkulosis pada anak-anak selain durasi kontak dengan penderita adalah status gizi, lalu diikuti status imunisasi, jumlah orang yang tinggal dalam satu rumah, dan kebiasaan tidur dalam satu ranjang (Hajarsyah et al, 2018).…”