Socio-economic status and risk of tuberculosis: a case-control study of HIV-infected patients in Asia

SETTING: Tuberculosis (TB) is the most common human immunodeficiency virus (HIV) related opportunistic infection and cause of acquired immune-deficiency syndrome related death. TB often affects those from a low socio-economic background. OBJECTIVE : To assess the socio-economic determinants of TB in...

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Main Authors: Jiamsakul, Awachana, Lee, Man Po, Nguyen, Kinh Van, Merati, Tuti Parwati, Cuong, Do Duy, Ditangco, Rossana, Yunihastuti, Evy, Ponnampalavanar, Sasheela, Zhang, Fujie, Kiertiburanakul, Sasisopin, Avihingasanon, Anchalee, Ng, Oon Tek, Sim, Benedict Lim Heng, Wong, Wing Wai, Ross, Jeremy, Law, Matthew
Format: Article
Published: International Union Against Tuberculosis and Lung Disease 2018
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Online Access:http://eprints.um.edu.my/21739/
https://doi.org/10.5588/ijtld.17.0348
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Summary:SETTING: Tuberculosis (TB) is the most common human immunodeficiency virus (HIV) related opportunistic infection and cause of acquired immune-deficiency syndrome related death. TB often affects those from a low socio-economic background. OBJECTIVE : To assess the socio-economic determinants of TB in HIV-infected patients in Asia. DESIGN: This was a matched case-control study. HIVpositive, TB-positive cases were matched to HIVpositive, TB-negative controls according to age, sex and CD4 cell count. A socio-economic questionnaire comprising 23 questions, including education level, employment, housing and substance use, was distributed. Socio-economic risk factors for TB were analysed using conditional logistic regression analysis. RESULT S : A total of 340 patients (170 matched pairs) were recruited, with 262 (77.1%) matched for all three criteria. Pulmonary TB was the predominant type (n = 115, 67.6%). The main risk factor for TB was not having a university level education (OR 4.45, 95%CI 1.50-13.17, P=0.007). Burning wood or coal regularly inside the house and living in the same place of origin were weakly associated with TB diagnosis. CONCLUS IONS : These data suggest that lower socioeconomic status is associated with an increased risk of TB in Asia. Integrating clinical and socio-economic factors into HIV treatment may help in the prevention of opportunistic infections and disease progression.