Modifiable risk factors associated with tuberculosis disease in children in Pune, India

Jennifer Jubulis, A. Kinikar, M. Ithape, M. Khandave, S. Dixit, S. Hotalkar, V. Kulkarni, Vidya Mave, Nikhil Gupte, A. Kagal, Sanjay Jain, R. Bharadwaj, Amita Gupta

Research output: Contribution to journalArticle

Abstract

SETTING: India accounts for the largest burden of tuberculosis (TB) worldwide, with 26% of the world's cases. OBJECTIVE: To assess the association between novel modifiable risk factors and TB in Indian children. DESIGN: Cases were children aged ≤5 years with c onfirmed/probable TB based on World Health Organization definitions (definition 1). Controls were healthy children aged ≤5 years. Logistic regression was performed to estimate the adjusted odds ratio (aOR) of being a TB case given exposure, including indoor air pollution (IAP; exposure to tobacco smoke and/or biomass fuels) and vitamin D deficiency. Cases were re-analyzed according to a new consensus research definition of pediatric TB (definition 2). RESULTS: Sixty cases and 118 controls were enrolled.Both groups had high levels of vitamin D deficiency (55% vs. 50%, P = 0.53). In multivariable analysis, TB was associated with household TB exposure (aOR 25.41, 95%CI 7.03-91.81), household food insecurity (aOR 11.55, 95%CI 3.33-40.15) and IAP exposure (aOR 2.67, 95%CI 1.02-6.97), but not vitamin D deficiency (aOR 1.00, 95%CI 0.38-2.66). Use of definition 2 reduced the number of cases to 25. In multivariate analysis, TB exposure, household food insecurity and IAP remained associated with TB. CONCLUSIONS: Household TB exposure, exposure to IAP and household food insecurity were independently associated with pediatric TB.

Original languageEnglish (US)
Pages (from-to)198-204
Number of pages7
JournalInternational Journal of Tuberculosis and Lung Disease
Volume18
Issue number2
DOIs
StatePublished - Feb 1 2014

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India
Tuberculosis
Odds Ratio
Vitamin D Deficiency
Food Supply
Pediatrics
Indoor Air Pollution
Smoke
Biomass
Tobacco
Consensus
Multivariate Analysis
Logistic Models
Research

Keywords

  • Household food insecurity
  • Indoor air pollution
  • Pediatric tuberculosis
  • Vitamin D deficiency

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Infectious Diseases

Cite this

Modifiable risk factors associated with tuberculosis disease in children in Pune, India. / Jubulis, Jennifer; Kinikar, A.; Ithape, M.; Khandave, M.; Dixit, S.; Hotalkar, S.; Kulkarni, V.; Mave, Vidya; Gupte, Nikhil; Kagal, A.; Jain, Sanjay; Bharadwaj, R.; Gupta, Amita.

In: International Journal of Tuberculosis and Lung Disease, Vol. 18, No. 2, 01.02.2014, p. 198-204.

Research output: Contribution to journalArticle

Jubulis, J, Kinikar, A, Ithape, M, Khandave, M, Dixit, S, Hotalkar, S, Kulkarni, V, Mave, V, Gupte, N, Kagal, A, Jain, S, Bharadwaj, R & Gupta, A 2014, 'Modifiable risk factors associated with tuberculosis disease in children in Pune, India', International Journal of Tuberculosis and Lung Disease, vol. 18, no. 2, pp. 198-204. https://doi.org/10.5588/ijtld.13.0314
Jubulis, Jennifer ; Kinikar, A. ; Ithape, M. ; Khandave, M. ; Dixit, S. ; Hotalkar, S. ; Kulkarni, V. ; Mave, Vidya ; Gupte, Nikhil ; Kagal, A. ; Jain, Sanjay ; Bharadwaj, R. ; Gupta, Amita. / Modifiable risk factors associated with tuberculosis disease in children in Pune, India. In: International Journal of Tuberculosis and Lung Disease. 2014 ; Vol. 18, No. 2. pp. 198-204.
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AU - Dixit, S.

AU - Hotalkar, S.

AU - Kulkarni, V.

AU - Mave, Vidya

AU - Gupte, Nikhil

AU - Kagal, A.

AU - Jain, Sanjay

AU - Bharadwaj, R.

AU - Gupta, Amita

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N2 - SETTING: India accounts for the largest burden of tuberculosis (TB) worldwide, with 26% of the world's cases. OBJECTIVE: To assess the association between novel modifiable risk factors and TB in Indian children. DESIGN: Cases were children aged ≤5 years with c onfirmed/probable TB based on World Health Organization definitions (definition 1). Controls were healthy children aged ≤5 years. Logistic regression was performed to estimate the adjusted odds ratio (aOR) of being a TB case given exposure, including indoor air pollution (IAP; exposure to tobacco smoke and/or biomass fuels) and vitamin D deficiency. Cases were re-analyzed according to a new consensus research definition of pediatric TB (definition 2). RESULTS: Sixty cases and 118 controls were enrolled.Both groups had high levels of vitamin D deficiency (55% vs. 50%, P = 0.53). In multivariable analysis, TB was associated with household TB exposure (aOR 25.41, 95%CI 7.03-91.81), household food insecurity (aOR 11.55, 95%CI 3.33-40.15) and IAP exposure (aOR 2.67, 95%CI 1.02-6.97), but not vitamin D deficiency (aOR 1.00, 95%CI 0.38-2.66). Use of definition 2 reduced the number of cases to 25. In multivariate analysis, TB exposure, household food insecurity and IAP remained associated with TB. CONCLUSIONS: Household TB exposure, exposure to IAP and household food insecurity were independently associated with pediatric TB.

AB - SETTING: India accounts for the largest burden of tuberculosis (TB) worldwide, with 26% of the world's cases. OBJECTIVE: To assess the association between novel modifiable risk factors and TB in Indian children. DESIGN: Cases were children aged ≤5 years with c onfirmed/probable TB based on World Health Organization definitions (definition 1). Controls were healthy children aged ≤5 years. Logistic regression was performed to estimate the adjusted odds ratio (aOR) of being a TB case given exposure, including indoor air pollution (IAP; exposure to tobacco smoke and/or biomass fuels) and vitamin D deficiency. Cases were re-analyzed according to a new consensus research definition of pediatric TB (definition 2). RESULTS: Sixty cases and 118 controls were enrolled.Both groups had high levels of vitamin D deficiency (55% vs. 50%, P = 0.53). In multivariable analysis, TB was associated with household TB exposure (aOR 25.41, 95%CI 7.03-91.81), household food insecurity (aOR 11.55, 95%CI 3.33-40.15) and IAP exposure (aOR 2.67, 95%CI 1.02-6.97), but not vitamin D deficiency (aOR 1.00, 95%CI 0.38-2.66). Use of definition 2 reduced the number of cases to 25. In multivariate analysis, TB exposure, household food insecurity and IAP remained associated with TB. CONCLUSIONS: Household TB exposure, exposure to IAP and household food insecurity were independently associated with pediatric TB.

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