Clinical Infection Medicine, Department of Translational Medicine, Lund University, Malmö, Sweden.
Department of Infectious Diseases, Central Hospital, Kristianstad, Sweden.
Clin Infect Dis. 2021 Jul 15;73(2):203-210. doi: 10.1093/cid/ciaa561.
Knowledge on tuberculosis (TB) infection epidemiology in women of reproductive age living in TB-endemic areas is limited. We used a composite definition of TB infection in a cohort of pregnant women recruited in an Ethiopian city as a model for TB exposure patterns, and to identify factors associated with TB infection.
Women seeking antenatal care at public health facilities underwent structured interviews, physical examination, and QuantiFERON-TB Gold-Plus (QFT) testing. Women with symptoms compatible with TB disease, and all human immunodeficiency virus (HIV)-positive women, were investigated for active TB by sputum bacteriological testing. TB infection (TB+) was defined as either positive QFT (≥ 0.35 IU/mL), self-reported previous active TB, or current active TB. Associations between TB infection and clinical, demographic, and socioeconomic characteristics were tested in multiple logistic regression analysis.
Among 1834 participants, 679 (37.0%) met criteria for TB+ (80 [4.4%] previous active TB, 5 [0.3%] current active TB, and 594 [32.4%] QFT-positive without previous or current active TB). Age (annual adjusted odds ratio [AOR], 1.069 [95% confidence interval {CI}, 1.045-1.093]) and HIV infection (AOR, 1.43 [95% CI, 1.033-1.988]) were independently associated with TB+. The relationship with increasing age was only observed in HIV-negative women, and translated to an estimated annual risk of TB infection of 2.1% in HIV-negative women.
TB infection in women of reproductive age in Ethiopia was independently associated with HIV infection and increasing age, suggesting exposure to contagious TB and continuous acquisition of TB infection in this population.
有关结核病（TB）感染在结核病流行地区生育年龄妇女中的流行病学知识有限。我们使用了一种在埃塞俄比亚城市招募的孕妇队列中的复合 TB 感染定义作为 TB 暴露模式的模型，并确定了与 TB 感染相关的因素。
在公立卫生机构寻求产前护理的妇女接受了结构化访谈、身体检查和 QuantiFERON-TB Gold-Plus（QFT）检测。有与 TB 疾病症状相符的妇女，以及所有 HIV 阳性的妇女，均通过痰细菌学检测来调查活动性 TB。TB 感染（TB+）定义为 QFT 阳性（≥0.35IU/mL）、自述曾患活动性 TB 或当前患有活动性 TB。在多元逻辑回归分析中，测试了 TB 感染与临床、人口统计学和社会经济特征之间的关联。
在 1834 名参与者中，有 679 名（37.0%）符合 TB+标准（80 名[4.4%]曾患活动性 TB、5 名[0.3%]当前患有活动性 TB、594 名[32.4%] QFT 阳性但无既往或当前活动性 TB）。年龄（每年调整后的优势比[AOR]，1.069[95%置信区间{CI}，1.045-1.093]）和 HIV 感染（AOR，1.43[95%CI，1.033-1.988]）与 TB+独立相关。与年龄增加相关的关系仅在 HIV 阴性妇女中观察到，并且估计 HIV 阴性妇女中每年 TB 感染的风险为 2.1%。
在埃塞俄比亚生育年龄的妇女中，TB 感染与 HIV 感染和年龄增加独立相关，这表明该人群存在传染性 TB 暴露和持续获得 TB 感染。
