| Summary: | 碩士 === 慈濟大學 === 公共衛生研究所 === 97 === This primary propose of the current case-control study was to identify the determinants of family tuberculosis aggregation after exposure to the Mycobacterium tuberculosis.
The study subjects were 4892 tuberculosis patients who were identified during 1995 to 2007. The case group included index cases of 278 families with tuberculosis aggregation and the control group included the other sporadic TB cases (N=4614). The informations associated with demographic and clinical characteristics and treatment outcomes were all abstracted from the dataset of the Notifiable Infectious Diseases, Center of Disease Control, Taiwan. The logistic regression was used to assess the strength of association between risk of family TB aggregation and explanatory factors. Among the 278 families with TB aggregation, 152 (55%) of them had at least three TB cases. In one TB family, there were 15 TB cases. At the township level, Sioulin Township had the highest prevalent rate of TB aggregation (437.28�e10-4).
Univariate analyses showed that female sex, younger age, and those who lived in mountainous areas were associated with significantly risk of family TB aggregation. Positivity for the sputumn smear, onset before 1995, chest cavities by X ray, resistance to medication during treatment, and retreatment were also associated with elevated risk of family TB aggregation. As compared with those who were ≧65 years of age, the multivariate-adjusted ORs of family TB aggregation for subjects who were 15~25 years old ranged from 2.1 to 2.2. The multivariate-adjusted ORs for subjects who were 0~14 or 45~64 years old were non-significantly elevated. As compared with those who resided in urban townships, the risks of family TB aggregation for subjects who resided in mountainous and rural townships were both significantly elevated, with ORs ranged from 28.5 to 32.3 and from 4.6 to 5.1, respectively. The multivariate-adjusted ORs for subjects who were identfied before 1995 were 17.5~25.4 folds higher than those who were identfied after 1996. As compared with those who were negative for both sputumn smear and culture, the multivariate-adjusted ORs ranged from 1.9 to 2.6. The multivariate-adjusted ORs for chest cavities by X-rays, retreatment, and resistance to medication during treatment ranged 1.9 to 2.2.
Our results indicated that several modifiable and non- modifiable risk factors were significantly associated with family TB aggregation in Hualien County. However, this study that was based on an available dataset of CDC, consequently, failed to assess the influences of socio-economical, cultural, and environmental factors. And, this study was also possibly restricted by the in-completness and inaccuracy of the dataset being used. We suggest that future researches on this topic should put more effort to collect clinical informations from medical charts and to collect informations associated with demographic, socio-economical, and cultural factors by using in-person interview.
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