Prevalence and Risk Factors for Adult Pulmonary Tuberculosis in a Metropolitan City of South India

Abstract

BackgroundThe present study measured the community prevalence and risk factors of adult pulmonary tuberculosis (PTB) in Chennai city, and also studied geographical distribution and the presence of different M. tuberculosis strains in the survey area.MethodsA community-based cross sectional survey was carried out from July 2010 to October 2012 in Chennai city. Prevalence of bacteriologically positive PTB was estimated by direct standardization method. Univariate and multivariate analyses were carried out to identify significant risk factors. Drug susceptibility testing and spoligotyping was performed on isolated M. tuberculosis strains. Mapping of PTB cases was done using geographic positioning systems.ResultsOf 59,957 eligible people, 55,617 were screened by X-ray and /or TB symptoms and the prevalence of smear, culture, and bacteriologically positive PTB was estimated to be 228 (95% CI 189–265), 259 (95% CI 217–299) and 349 (95% CI 330–428) per 100,000 population, respectively. Prevalence of smear, culture, and bacteriologically positive PTB was highest amongst men aged 55–64 years. Multivariate analysis showed that occurrence of both culture and bacteriologically positive PTB disease was significantly associated with: age >35 years, past history of TB treatment, BMI <18.5 Kgs/m2, solid cooking fuel, and being a male currently consuming alcohol. The most frequent spoligotype family was East African Indian. Spatial distribution showed that a high proportion of patients were clustered in the densely populated north eastern part of the city.ConclusionOur findings demonstrate that TB is a major public health problem in this urban area of south India, and support the use of intensified case finding in high risk groups. Undernutrition, slum dwelling, indoor air pollution and alcohol intake are modifiable risk factors for TB disease.

Sex Differences in Tuberculosis Burden and Notifications in Low- and Middle-Income Countries: A Systematic Review and Meta-analysis

“…Forty surveys with 1.7 million participants in 22 countries reported the prevalence of smear-positive TB by sex [35,40,43,44,48–51,53,55,56,58–60,65–67,69–71,73,74,85,87,89,90,92,94,97,101,102,105,107,110,111]. The overall random-effects weighted prevalence per 100,000 individuals was 488 (95% CI 382–623) among men and 231 (95% CI 166–321) among women for bacteriologically positive TB and 314 (95% CI 245–403) among men and 129 (95% CI 89–189) among women for smear-positive TB (S3 Table).…”

Spatial distribution of tuberculosis in a municipality in the interior of São Paulo, 2008-2013

“…In this context, studies carried out in India and Brazil on the spatial distribution of TB indicate that in addition to the clinical characteristics of the individual, TB is also associated with different socioeconomic factors, such as income, schooling and household quality which must be considered in the definition of strategies for TB surveillance and control 4 .…”

Tobacco smoking trends and treatment outcomes in Tuberculosis patients of district Shimla, Himachal Pradesh, India: a cohort study

“…Various international and Indian studies have found positive associations between overcrowding and poor ventilation with higher prevalence of TB. [8][9][10][11] In the present study, a considerable number of patients were exposed to inadequate ventilation [54 (46.1%)] while Overcrowding was not observed in the majority of the patients [6 (5.1%)].…”