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. 2014 Feb;18(2):198-204.
doi: 10.5588/ijtld.13.0314.

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

J Jubulis  1 , A Kinikar  2 , M Ithape  3 , M Khandave  3 , S Dixit  2 , S Hotalkar  3 , V Kulkarni  3 , V Mave  3 , N Gupte  3 , A Kagal  3 , S Jain  4 , R Bharadwaj  3 , A Gupta  4
Affiliations

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

J Jubulis et al. Int J Tuberc Lung Dis. 2014 Feb.

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 confirmed/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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Conflict of interest statement

Conflict of interest: none declared.

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