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. 2022 Jul 12;17(7):e0262978.
doi: 10.1371/journal.pone.0262978. eCollection 2022.

Hierarchical true prevalence, risk factors and clinical symptoms of tuberculosis among suspects in Bangladesh

Mohammad Kamruzzaman Khan  1   2 , Md Nazimul Islam  1 , Jayedul Hassan  3 , Shaymal Kumar Paul  4 , M Ariful Islam  1 , Konstantinos Pateras  5 , Polychronis Kostoulas  5 , Michael P Ward  6 , A K M Anisur Rahman  1 , Md Mahbub Alam  1
Affiliations

Hierarchical true prevalence, risk factors and clinical symptoms of tuberculosis among suspects in Bangladesh

Mohammad Kamruzzaman Khan et al. PLoS One. .

Abstract

Background: The study was aimed to estimate the true prevalence of human tuberculosis (TB); identify risk factors and clinical symptoms of TB; and detect rifampicin (RIF) sensitivity in three study areas of Bangladesh.

Methods: The cross-sectional study was conducted in three Bangladesh districts during 2018. Potential risk factors, clinical symptoms, and comorbidities were collected from 684 TB suspects. Sputum specimens were examined by LED microscopy. TB hierarchical true prevalence, risk factors and clinical symptoms were estimated and identified using a Bayesian analysis framework. Rifampicin sensitivity of M. tuberculosis (MTB) was detected by GeneXpert MTB/RIF assay.

Results: The median TB true prevalence was 14.2% (3.8; 34.5). Although overall clustering of prevalence was not found, several DOTS centers were identified with high prevalence (22.3% to 43.7%). Risk factors for TB identified (odds ratio) were age (> 25 to 45 years 2.67 (1.09; 6.99), > 45 to 60 years 3.43 (1.38; 9.19) and individuals in families/neighborhoods where a TB patient(s) has (ve) already been present (12.31 (6.79; 22.60)). Fatigue, night sweat, fever and hemoptysis were identified as important clinical symptoms. Seven of the GeneXpert MTB/RIF positive sputum specimens (65) were resistant to rifampicin.

Conclusions: About one in every seven TB suspects was affected with TB. A number of the TB patients carry multi drug resistant MTB. Hierarchical true prevalence estimation allowed identifying DOTS centers with high TB burden. Insights from this study will enable more efficient use of DOTScenters-based TB surveillance to end the TB epidemic in Bangladesh by 2035.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Boxplots showing the DOTS centers level true prevalence of TB among suspects in Mymensingh, Sirajganj and Dhaka districts of Bangladesh.
See this image and copyright information in PMC

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