Advanced

Tuberculosis in Bissau: incidence and risk factors in an urban community in sub-Saharan Africa

Gustafson, Per LU ; Gomes, VF; Vieira, CS; Rabna, P; Seng, R; Johansson, P; Sandstrom, A; Norberg, R; Lisse, I and Samb, B, et al. (2004) In International Journal of Epidemiology 33(1). p.163-172
Abstract
Background Despite the long history of tuberculosis (TB) research, population-based studies from developing countries are rare. Methods In a prospective community study in Bissau, the capital of Guinea-Bissau, we assessed the impact of demographic, socioeconomic and cultural risk factors on active TB. A surveillance system in four districts of the capital identified 247 adult (greater than or equal to15 years) cases of intrathoracic TB between May 1996 and June 1998. Risk factors were evaluated comparing cases with the 25 189 adults living in the area in May 1997. Results The incidence of intrathoracic TB in the adult population was 471 per 100 000 person-years. Significant risk factors in a multivariate analysis were increasing age (P... (More)
Background Despite the long history of tuberculosis (TB) research, population-based studies from developing countries are rare. Methods In a prospective community study in Bissau, the capital of Guinea-Bissau, we assessed the impact of demographic, socioeconomic and cultural risk factors on active TB. A surveillance system in four districts of the capital identified 247 adult (greater than or equal to15 years) cases of intrathoracic TB between May 1996 and June 1998. Risk factors were evaluated comparing cases with the 25 189 adults living in the area in May 1997. Results The incidence of intrathoracic TB in the adult population was 471 per 100 000 person-years. Significant risk factors in a multivariate analysis were increasing age (P < 0.0001), male sex (odds ratio [OR] = 2.58, 95% CI: 1.85, 3.60), ethnic group other than the largest group (Pepel) (OR = 1.64, 95% CI: 1.20, 2.22), adult crowding (OR = 1.68, 95% CI: 1.18, 2.39 for >2 adults in household), and poor quality of housing (OR = 1.66, 95% CI: 1.24, 2.22). Household type was important; adults living alone or with adults of their own sex only, had a higher risk of developing TB than households with husband and wife present, the adjusted OR being 1.76 (95% CI: 1.11, 2.78) for male households and 3.80 (95% CI: 1.69, 8.56) for female households. In a multivariate analysis excluding household type, child crowding was a protective factor, the OR being 0.68 (95% CI: 0.51, 0.90) for households with >2 children per household. Conclusions Bissau has a very high incidence of intrathoracic TB. Human immunodeficiency virus (HIV), increasing age, male sex, ethnicity, adult crowding, family structure, and poor housing conditions were independent risk factors for TB. Apart from HIV prevention, TB control programmes need to emphasize risk factors such as socioeconomic inequality, ethnic differences, crowding, and gender. (Less)
Please use this url to cite or link to this publication:
author
, et al. (More)
(Less)
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
tuberculosis, community study, risk factor, sub-Saharan, Africa, HIV infection, incidence
in
International Journal of Epidemiology
volume
33
issue
1
pages
163 - 172
publisher
Oxford University Press
external identifiers
  • pmid:15075165
  • wos:000220615000031
  • scopus:3042649639
ISSN
1464-3685
DOI
10.1093/ije/dyh026
language
English
LU publication?
yes
id
377e78c8-8a70-49a1-a7a7-457f2c022da3 (old id 899170)
date added to LUP
2008-01-10 15:53:24
date last changed
2017-11-12 03:29:24
@article{377e78c8-8a70-49a1-a7a7-457f2c022da3,
  abstract     = {Background Despite the long history of tuberculosis (TB) research, population-based studies from developing countries are rare. Methods In a prospective community study in Bissau, the capital of Guinea-Bissau, we assessed the impact of demographic, socioeconomic and cultural risk factors on active TB. A surveillance system in four districts of the capital identified 247 adult (greater than or equal to15 years) cases of intrathoracic TB between May 1996 and June 1998. Risk factors were evaluated comparing cases with the 25 189 adults living in the area in May 1997. Results The incidence of intrathoracic TB in the adult population was 471 per 100 000 person-years. Significant risk factors in a multivariate analysis were increasing age (P &lt; 0.0001), male sex (odds ratio [OR] = 2.58, 95% CI: 1.85, 3.60), ethnic group other than the largest group (Pepel) (OR = 1.64, 95% CI: 1.20, 2.22), adult crowding (OR = 1.68, 95% CI: 1.18, 2.39 for &gt;2 adults in household), and poor quality of housing (OR = 1.66, 95% CI: 1.24, 2.22). Household type was important; adults living alone or with adults of their own sex only, had a higher risk of developing TB than households with husband and wife present, the adjusted OR being 1.76 (95% CI: 1.11, 2.78) for male households and 3.80 (95% CI: 1.69, 8.56) for female households. In a multivariate analysis excluding household type, child crowding was a protective factor, the OR being 0.68 (95% CI: 0.51, 0.90) for households with &gt;2 children per household. Conclusions Bissau has a very high incidence of intrathoracic TB. Human immunodeficiency virus (HIV), increasing age, male sex, ethnicity, adult crowding, family structure, and poor housing conditions were independent risk factors for TB. Apart from HIV prevention, TB control programmes need to emphasize risk factors such as socioeconomic inequality, ethnic differences, crowding, and gender.},
  author       = {Gustafson, Per and Gomes, VF and Vieira, CS and Rabna, P and Seng, R and Johansson, P and Sandstrom, A and Norberg, R and Lisse, I and Samb, B and Aaby, P and Nauclér, Anders},
  issn         = {1464-3685},
  keyword      = {tuberculosis,community study,risk factor,sub-Saharan,Africa,HIV infection,incidence},
  language     = {eng},
  number       = {1},
  pages        = {163--172},
  publisher    = {Oxford University Press},
  series       = {International Journal of Epidemiology},
  title        = {Tuberculosis in Bissau: incidence and risk factors in an urban community in sub-Saharan Africa},
  url          = {http://dx.doi.org/10.1093/ije/dyh026},
  volume       = {33},
  year         = {2004},
}