Prevalence and risk factors of latent Tuberculosis among adolescents in rural Eastern Uganda

Abstract

Background: Latent Tuberculosis treatment is a key tuberculosis control intervention. Adolescents are a high risk group that is not routinely treated in low income countries. Knowledge of latent Tuberculosis (TB) burden among adolescents may influence policy. Objectives: We determined the prevalence and risk factors of latent TB infection among adolescents in rural Uganda. Methods: We analyzed baseline data from a study that assessed the prevalence and incidence of Tuberculosis disease among adolescents. We extracted socio-demographics, medical assessment information, and tuberculin skin test results and estimated prevalence ratios (PR) of latent TB infection risk factors by binomial regression. Results: The prevalence of latent TB was 16.1%, 95% CI (15.1 -17.2). Significant risk factors were: a BCG scar, APR 1.29 (95% CI 1.12 -1.48); male gender, APR 1.37 (95% CI 1.21 -1.56); age 17 -18 years, APR 1.46 (95% CI 1.24 -1.71) and 15-16 years, APR 1.25 (95% CI 1.07 -1.46) compared to 12-14 years; being out of school, APR 1.31 (95% CI 1.05 -1.62); and a known history of household TB contact in last 2 years, APR 1.91 (95% CI 1.55 -2.35) Conclusion: Targeted routine latent TB treatment among adolescents out of school may be crucial for TB disease control in low income countries.

Incidence and Predictive Factors of Latent Tuberclosis Infection amongst Personnel of Ayatollah Rouhani Hospital in Babol, 2015-2016

“…On the other hand, these results are consistent with studies conducted in 14 . However, the prevalence of LTBI in the present study was 14.7%, which was significantly lower than high risk health care worker populations in Thailand (63%), Uganda (57%), and the Netherlands (41%), which is justifiable due to the fact that Iran is an intermediate region in terms of endemicity 15,16 . The results of the present study showed that the incidence of LTBI in technicians (1.82%) and nurses (6.63%) was higher than other hospital personnel.…”

Estimating Tuberculin Skin Test Reactions among Children and Teenagers Who Received the Bacillus Calmette-Guerin Vaccination at Birth: A Meta-analysis

“…The reported prevalences in three studies [13–15] were higher than those of the current Iranian meta-analysis. Only the Gambian survey [16] showed lower estimates than Iran.…”

Clinical Development of New TB Vaccines: Recent Advances and Next Steps

“…Notably, although a post-exposure vaccination campaign among South African adolescents would include a greater proportion of IGRA-positive individuals than in China (Gao et al, 2015;Bunyasi et al, 2019), half of adolescent vaccinees would still be Mtb-uninfected. Lower prevalence rates of Mtb infection among adolescents in e.g., Kenya (32%) (Nduba et al, 2019) and Uganda (16%) (Mumpe-Mwanja et al, 2015), would favor a preexposure rather than a post-exposure approach for adolescents in these and other countries with lower Mtb transmission rates (Gao et al, 2015). This distinction is important, because TB FIGURE 1 | Target populations for new TB vaccines include Mtb-uninfected (pre-exposure) and Mtb-infected, TB diseased, and treated individuals (post-exposure).…”

“…It is not known whether a two-dose M72/AS01 E vaccination regimen offers the same level of protection to IGRA-negative and IGRA-positive individuals; whether priming by Mtb infection is a necessary component of the M72/AS01 E vaccine-induced protection observed in IGRA-positive people; and if so, whether adolescent BCG revaccination could fulfill that priming function prior to M72/AS01 E vaccination of IGRA-negative adults. The issue of efficacy in IGRA-negative individuals is particularly crucial for age-targeted vaccination of children and adolescents, who have lower prevalence rates of Mtb infection than adults (Mahomed et al, 2006(Mahomed et al, , 2011b, and for mass campaigns in countries such as Kenya (Nduba et al, 2019), Uganda (Mumpe-Mwanja et al, 2015), and China (Gao et al, 2015), where the majority of the adult population is Mtb-uninfected. Efficacy data for pre-exposure vaccination of IGRA-negative populations will likely be crucial to motivate the health system use case, even in high TB burden countries, and any Phase 3 trial should be adequately powered to provide a definitive answer to this question.…”