Prevalence of latent tuberculosis infection and predictive factors in an urban informal settlement in Johannesburg, South Africa: a cross-sectional study

Abstract Background South Africa has one of the highest burdens of latent tuberculosis infection (LTBI) in high-risk populations such as young children, adolescents, household contacts of TB cases, people living with HIV, gold miners and health care workers, but little is known about the burden of L...

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Main Authors: Jabulani R. Ncayiyana, Jean Bassett, Nora West, Daniel Westreich, Eustasius Musenge, Michael Emch, Audrey Pettifor, Colleen F. Hanrahan, Sheree R. Schwartz, Ian Sanne, Annelies van Rie
Format: Article
Language:English
Published: BMC 2016-11-01
Series:BMC Infectious Diseases
Subjects:
ARI
Online Access:http://link.springer.com/article/10.1186/s12879-016-1989-x
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spelling doaj-f2e257f3de9043338f3524ade0fcaa782020-11-25T03:37:15ZengBMCBMC Infectious Diseases1471-23342016-11-0116111010.1186/s12879-016-1989-xPrevalence of latent tuberculosis infection and predictive factors in an urban informal settlement in Johannesburg, South Africa: a cross-sectional studyJabulani R. Ncayiyana0Jean Bassett1Nora West2Daniel Westreich3Eustasius Musenge4Michael Emch5Audrey Pettifor6Colleen F. Hanrahan7Sheree R. Schwartz8Ian Sanne9Annelies van Rie10Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel HillWitkoppen Health and Welfare CentreWitkoppen Health and Welfare CentreDepartment of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel HillDivision of Epidemiology and Biostatistics, School of Public Health, Faculty of Health Sciences, University of the WitwatersrandDepartment of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel HillDepartment of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel HillDepartment of Epidemiology, Bloomberg School of Public Health, Johns Hopkins UniversityDepartment of Epidemiology, Bloomberg School of Public Health, Johns Hopkins UniversityClinical HIV Research Unit, Department of Medicine, University of the WitwatersrandDepartment of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel HillAbstract Background South Africa has one of the highest burdens of latent tuberculosis infection (LTBI) in high-risk populations such as young children, adolescents, household contacts of TB cases, people living with HIV, gold miners and health care workers, but little is known about the burden of LTBI in its general population. Methods Using a community-based survey with random sampling, we examined the burden of LTBI in an urban township of Johannesburg and investigated factors associated with LTBI. The outcome of LTBI was based on TST positivity, with a TST considered positive if the induration was ≥5 mm in people living with HIV or ≥10 mm in those with unknown or HIV negative status. We used bivariate and multivariable logistic regression to identify factors associated with LTBI Results The overall prevalence of LTBI was 34.3 (95 % CI 30.0, 38.8 %), the annual risk of infection among children age 0–14 years was 3.1 % (95 % CI 2.1, 5.2). LTBI was not associated with HIV status. In multivariable logistic regression analysis, LTBI was associated with age (OR = 1.03 for every year increase in age, 95 % CI = 1.01–1.05), male gender (OR = 2.70, 95 % CI = 1.55–4.70), marital status (OR = 2.00, 95 % CI = 1.31–3.54), and higher socio-economic status (OR = 2.11, 95 % CI = 1.04–4.31). Conclusions The prevalence of LTBI and the annual risk of infection with M. tuberculosis is high in urban populations, especially in men, but independent of HIV infection status. This study suggests that LTBI may be associated with higher SES, in contrast to the well-established association between TB disease and poverty.http://link.springer.com/article/10.1186/s12879-016-1989-xSouth AfricaLTBIPrevalenceARIRisk factorsUrban population
collection DOAJ
language English
format Article
sources DOAJ
author Jabulani R. Ncayiyana
Jean Bassett
Nora West
Daniel Westreich
Eustasius Musenge
Michael Emch
Audrey Pettifor
Colleen F. Hanrahan
Sheree R. Schwartz
Ian Sanne
Annelies van Rie
spellingShingle Jabulani R. Ncayiyana
Jean Bassett
Nora West
Daniel Westreich
Eustasius Musenge
Michael Emch
Audrey Pettifor
Colleen F. Hanrahan
Sheree R. Schwartz
Ian Sanne
Annelies van Rie
Prevalence of latent tuberculosis infection and predictive factors in an urban informal settlement in Johannesburg, South Africa: a cross-sectional study
BMC Infectious Diseases
South Africa
LTBI
Prevalence
ARI
Risk factors
Urban population
author_facet Jabulani R. Ncayiyana
Jean Bassett
Nora West
Daniel Westreich
Eustasius Musenge
Michael Emch
Audrey Pettifor
Colleen F. Hanrahan
Sheree R. Schwartz
Ian Sanne
Annelies van Rie
author_sort Jabulani R. Ncayiyana
title Prevalence of latent tuberculosis infection and predictive factors in an urban informal settlement in Johannesburg, South Africa: a cross-sectional study
title_short Prevalence of latent tuberculosis infection and predictive factors in an urban informal settlement in Johannesburg, South Africa: a cross-sectional study
title_full Prevalence of latent tuberculosis infection and predictive factors in an urban informal settlement in Johannesburg, South Africa: a cross-sectional study
title_fullStr Prevalence of latent tuberculosis infection and predictive factors in an urban informal settlement in Johannesburg, South Africa: a cross-sectional study
title_full_unstemmed Prevalence of latent tuberculosis infection and predictive factors in an urban informal settlement in Johannesburg, South Africa: a cross-sectional study
title_sort prevalence of latent tuberculosis infection and predictive factors in an urban informal settlement in johannesburg, south africa: a cross-sectional study
publisher BMC
series BMC Infectious Diseases
issn 1471-2334
publishDate 2016-11-01
description Abstract Background South Africa has one of the highest burdens of latent tuberculosis infection (LTBI) in high-risk populations such as young children, adolescents, household contacts of TB cases, people living with HIV, gold miners and health care workers, but little is known about the burden of LTBI in its general population. Methods Using a community-based survey with random sampling, we examined the burden of LTBI in an urban township of Johannesburg and investigated factors associated with LTBI. The outcome of LTBI was based on TST positivity, with a TST considered positive if the induration was ≥5 mm in people living with HIV or ≥10 mm in those with unknown or HIV negative status. We used bivariate and multivariable logistic regression to identify factors associated with LTBI Results The overall prevalence of LTBI was 34.3 (95 % CI 30.0, 38.8 %), the annual risk of infection among children age 0–14 years was 3.1 % (95 % CI 2.1, 5.2). LTBI was not associated with HIV status. In multivariable logistic regression analysis, LTBI was associated with age (OR = 1.03 for every year increase in age, 95 % CI = 1.01–1.05), male gender (OR = 2.70, 95 % CI = 1.55–4.70), marital status (OR = 2.00, 95 % CI = 1.31–3.54), and higher socio-economic status (OR = 2.11, 95 % CI = 1.04–4.31). Conclusions The prevalence of LTBI and the annual risk of infection with M. tuberculosis is high in urban populations, especially in men, but independent of HIV infection status. This study suggests that LTBI may be associated with higher SES, in contrast to the well-established association between TB disease and poverty.
topic South Africa
LTBI
Prevalence
ARI
Risk factors
Urban population
url http://link.springer.com/article/10.1186/s12879-016-1989-x
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