Mohan Aparna, Indu P S, Nair Sanjeev, Rakesh P S, Saradadevi K L, Rajahamsan Jyothi
Department of Community Medicine, Government Medical College, Thiruvananthapuram, Kerala, India.
Department of Respiratory Medicine, Government Medical College, Thiruvananthapuram, Kerala, India.
Indian J Community Med. 2022 Oct-Dec;47(4):501-505. doi: 10.4103/ijcm.ijcm_1322_21. Epub 2022 Dec 14.
To achieve the goals of the end tuberculosis (TB) strategy, strategies for management of TB infection (TBI) have to be expanded. The first step to devise policies is to understand the distribution and determinants of TBI in the community. The objectives of the study were to estimate the prevalence of TBI using Interferon Gamma Release Assay (IGRA) and its determinants among the adult population of Thiruvananthapuram district, Kerala.
A community-based, cross-sectional study using the stratified cluster sampling was carried out among the adults. TBI was detected using IGRA conducted on whole blood sample. Data on determinants were collected using a structured questionnaire by the face-to-face interview. The prevalence of TBI was estimated. Univariate and multivariate analysis was conducted to identify the determinants.
Age standardized prevalence of TBI among 396 adults was 20.5% (95% confidence interval [CI] 16.52-24.48). On adjusting for the possible confounders, increasing age (adjusted odds ratio [OR] 1.028; 95% CI 1.008-1.048; = 0.005), history of contact with active TB disease (adjusted OR 7.61; 95% CI 4.43-13.05; < 0.001), childhood contact (adjusted OR 8.20; 95% CI 3.14-21.41; < 0.001), and household contact (adjusted OR 10.12; 95% CI 5.39-18.98; < 0.001) were found to be the determinants of TBI in this population.
The present study observed that nearly one-fifth of the adult population in the Thiruvananthapuram district has TBI. For the programmatic management, factors such as increasing age and contact history may be considered for the elimination of TBI in the state.
为实现终结结核病战略目标,必须扩大结核感染(TBI)管理策略。制定政策的第一步是了解社区中TBI的分布及决定因素。本研究的目的是使用干扰素γ释放试验(IGRA)估计喀拉拉邦特里凡得琅地区成年人群中TBI的患病率及其决定因素。
在成年人中开展了一项基于社区的横断面研究,采用分层整群抽样。通过对全血样本进行IGRA检测TBI。通过面对面访谈,使用结构化问卷收集决定因素的数据。估计TBI的患病率。进行单因素和多因素分析以确定决定因素。
396名成年人中TBI的年龄标准化患病率为20.5%(95%置信区间[CI]16.52 - 24.48)。在对可能的混杂因素进行调整后,年龄增加(调整后的比值比[OR]1.028;95%CI 1.008 - 1.048;P = 0.005)、有活动性结核病接触史(调整后的OR 7.61;95%CI 4.43 - 13.05;P < 0.001)、儿童期接触(调整后的OR 8.20;95%CI 3.14 - 21.41;P < 0.001)和家庭接触(调整后的OR 10.12;95%CI 5.39 - 18.98;P < 0.001)被发现是该人群中TBI的决定因素。
本研究观察到,特里凡得琅地区近五分之一的成年人群患有TBI。对于规划管理而言,在该邦消除TBI时可考虑年龄增加和接触史等因素。