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Impact of tuberculosis exposure at home on mortality in children under 5 years of age in Guinea-Bissau

Gomes, Victor F.; Andersen, Andreas; Wejse, Christian; Oliveira, Ines; Vieira, Fina J.; Joaquim, Luis Carlos; Vieira, Cesaltina S.; Aaby, Peter and Gustafson, Per LU (2011) In Thorax 66(2). p.163-167
Abstract
Objective To assess mortality related to exposure to tuberculosis (TB) at home among children in urban areas of Guinea-Bissau. Methods In four suburban areas included in the demographic surveillance system of the Bandim Health Project in Bissau, the mortality of children aged <5 years living with an adult with TB was compared with the mortality of children in the general population. Results Children <5 years of age exposed to an adult with intrathoracic TB had 66% higher mortality than unexposed children (HR 1.66, 95% CI 1.2 to 2.3). The risk was higher for children living in the same family as a TB case (HR 2.15, 95% CI 1.3 to 3.7) than for children living in the same house but not belonging to the same family as the TB case (HR... (More)
Objective To assess mortality related to exposure to tuberculosis (TB) at home among children in urban areas of Guinea-Bissau. Methods In four suburban areas included in the demographic surveillance system of the Bandim Health Project in Bissau, the mortality of children aged <5 years living with an adult with TB was compared with the mortality of children in the general population. Results Children <5 years of age exposed to an adult with intrathoracic TB had 66% higher mortality than unexposed children (HR 1.66, 95% CI 1.2 to 2.3). The risk was higher for children living in the same family as a TB case (HR 2.15, 95% CI 1.3 to 3.7) than for children living in the same house but not belonging to the same family as the TB case (HR 1.51, 95% CI 1.0 to 2.2). For children whose mother had TB, mortality was increased eightfold (HR 7.82, 95% CI 2.1 to 30). The risk of death was particularly increased from 6 months following exposure (HR 2.16, 95% CI 1.5 to 3.2) and the highest rate of excess mortality was found in children aged 3-4 years. Excess mortality was highest among children with close contact with an adult with sputum-positive pulmonary TB (HR 1.90, 95% CI 1.1 to 3.2), but contact with a sputum-negative case was also associated with increased mortality (HR 1.55, 95% CI 1.0 to 2.3). Adjusting for potential confounding factors did not change these results. The mortality among children living in the same houses 3 years earlier was not increased (HR 0.90, 95% CI 0.6 to 1.3). Conclusion Intimate family contact with a TB case represents a significant risk factor for child mortality in a low-income country. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Thorax
volume
66
issue
2
pages
163 - 167
publisher
BMJ Publishing Group
external identifiers
  • wos:000286459000016
  • scopus:79251636433
ISSN
1468-3296
DOI
10.1136/thx.2010.141309
language
English
LU publication?
yes
id
0d22c7aa-19d0-49fc-9153-e79caa0a62b1 (old id 1876870)
date added to LUP
2011-04-01 11:53:15
date last changed
2017-11-12 03:43:10
@article{0d22c7aa-19d0-49fc-9153-e79caa0a62b1,
  abstract     = {Objective To assess mortality related to exposure to tuberculosis (TB) at home among children in urban areas of Guinea-Bissau. Methods In four suburban areas included in the demographic surveillance system of the Bandim Health Project in Bissau, the mortality of children aged &lt;5 years living with an adult with TB was compared with the mortality of children in the general population. Results Children &lt;5 years of age exposed to an adult with intrathoracic TB had 66% higher mortality than unexposed children (HR 1.66, 95% CI 1.2 to 2.3). The risk was higher for children living in the same family as a TB case (HR 2.15, 95% CI 1.3 to 3.7) than for children living in the same house but not belonging to the same family as the TB case (HR 1.51, 95% CI 1.0 to 2.2). For children whose mother had TB, mortality was increased eightfold (HR 7.82, 95% CI 2.1 to 30). The risk of death was particularly increased from 6 months following exposure (HR 2.16, 95% CI 1.5 to 3.2) and the highest rate of excess mortality was found in children aged 3-4 years. Excess mortality was highest among children with close contact with an adult with sputum-positive pulmonary TB (HR 1.90, 95% CI 1.1 to 3.2), but contact with a sputum-negative case was also associated with increased mortality (HR 1.55, 95% CI 1.0 to 2.3). Adjusting for potential confounding factors did not change these results. The mortality among children living in the same houses 3 years earlier was not increased (HR 0.90, 95% CI 0.6 to 1.3). Conclusion Intimate family contact with a TB case represents a significant risk factor for child mortality in a low-income country.},
  author       = {Gomes, Victor F. and Andersen, Andreas and Wejse, Christian and Oliveira, Ines and Vieira, Fina J. and Joaquim, Luis Carlos and Vieira, Cesaltina S. and Aaby, Peter and Gustafson, Per},
  issn         = {1468-3296},
  language     = {eng},
  number       = {2},
  pages        = {163--167},
  publisher    = {BMJ Publishing Group},
  series       = {Thorax},
  title        = {Impact of tuberculosis exposure at home on mortality in children under 5 years of age in Guinea-Bissau},
  url          = {http://dx.doi.org/10.1136/thx.2010.141309},
  volume       = {66},
  year         = {2011},
}