Singh Saurabh, Zahiruddin Quazi Syed, Lakhanpal Sorabh, Ballal Suhas, Kumar Sanjay, Bhat Mahakshit, Sharma Shilpa, Kumar M Ravi, Dhandh Yogesh Kumar, Rustagi Sarvesh, Alissa Mohammed, Halwani Muhammad A, Garout Mohammed, Alrasheed Hayam A, Al-Subaie Maha F, Al Kaabi Nawal A, Rabaan Ali A, Sah Sanjit, Shabil Muhammed, Khatib Mahalaqua Nazli, Satapathy Prakasini
International Institute for Population Sciences, Mumbai, India.
South Asia Infant Feeding Research Network (SAIFRN), Division of Evidence Synthesis, Global Consortium of Public Health and Research, Datta Meghe Institute of Higher Education, Wardha, India.
BMC Infect Dis. 2025 Jan 4;25(1):21. doi: 10.1186/s12879-024-10301-7.
Tuberculosis (TB) remains a significant health concern in India, especially among households with children and young adolescents aged 6-17 years. Despite ongoing research, there is a knowledge gap regarding specific risk factors for TB within this demographic. This study aims to bridge this gap by examining the association between TB and various socio-demographic factors, including socioeconomic status, nutritional status, and environmental conditions.
Utilizing data from the National Family Health Survey (NFHS) 4th and 5th round (2015-16 and 2019-21), this study conducted a comprehensive cross-sectional analysis. Unadjusted and Adjusted Logistic regression is utilized to identify key factors influencing TB. Furthermore, Wagstaff decomposition analysis is applied, to quantifying the factors that contributes to the inequalities in social determinants on the wealth-related inequality observed in the prevalence of TB.
The study observed a notable decline in TB prevalence from 1.7 to 1.2% among individuals from households having children and young adolescents aged 6-17 years. Additionally, factors like the use of unclean cooking fuel, lack of electricity, and unimproved toilet facilities were associated with increased TB prevalence. Wealth-based inequality in TB prevalence was also evident, with the burden falling disproportionately on poorer households. Unclean fuel is the most significant determinant of wealth-based inequality in TB, contributing to nearly 2/5th (18.5% in NFHS-4) of the observed inequality. Notably, gender did not significantly influence TB prevalence.
The decline in TB prevalence in India correlates with improvements in socio-economic and living conditions, as evidenced by increased access to better housing, clean fuel, and sanitation facilities. The study underscores the need for integrated public health strategies that address both medical and socio-environmental determinants of TB. Improving socio-economic conditions, alongside targeted healthcare interventions, appears vital in reducing the TB burden in high-prevalence settings like India. This research emphasizes the importance of comprehensive approaches to combat pediatric TB, combining clinical care with enhancements in living standards and access to basic amenities.
结核病在印度仍然是一个重大的健康问题，尤其是在有6至17岁儿童和青少年的家庭中。尽管研究不断，但在这一人群中，关于结核病的具体风险因素仍存在知识差距。本研究旨在通过考察结核病与各种社会人口因素之间的关联来填补这一差距，这些因素包括社会经济地位、营养状况和环境条件。
利用第四次和第五次全国家庭健康调查（NFHS）（2015 - 16年和2019 - 21年）的数据，本研究进行了全面的横断面分析。使用未调整和调整后的逻辑回归来确定影响结核病的关键因素。此外，应用瓦格斯塔夫分解分析来量化导致结核病患病率中观察到的与财富相关不平等的社会决定因素不平等的因素。
该研究观察到，在有6至17岁儿童和青少年的家庭中，结核病患病率从1.7%显著下降至1.2%。此外，使用不清洁的烹饪燃料、缺乏电力和卫生设施未改善等因素与结核病患病率增加有关。结核病患病率中基于财富的不平等也很明显，负担不成比例地落在较贫困家庭身上。不清洁燃料是结核病中基于财富不平等的最重要决定因素，导致近五分之二（NFHS - 4中为18.5%）观察到的不平等。值得注意的是，性别对结核病患病率没有显著影响。
印度结核病患病率的下降与社会经济和生活条件的改善相关，更好的住房、清洁燃料和卫生设施的可及性增加证明了这一点。该研究强调需要综合公共卫生策略，解决结核病的医学和社会环境决定因素。改善社会经济条件以及有针对性的医疗保健干预措施，对于减轻印度等高患病率地区的结核病负担似乎至关重要。这项研究强调了综合方法对抗儿童结核病的重要性，将临床护理与生活水平提高和基本便利设施的可及性相结合。
