1921
Volume 80, Issue 6
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645

Abstract

This study aimed to assess the association between household socioeconomic position and tuberculosis (TB) infection in two communities of Zambia. For this purpose we implemented a cross-sectional investigation, nested within a larger case control study. Infection was assessed using Quantiferon-TB Gold. A socioeconomic position index was constructed through principal component analysis combining data on human resources, food availability, housing quality, and access to services and infrastructures. In this study, higher socioeconomic position, rather than lower, was associated with significantly higher risk of TB infection. None of the traditional risk factors for TB infection mediated this association, suggesting that in these two communities TB transmission may occur through exposure to as yet undefined risk factors that are associated with higher socioeconomic position. Although further studies are needed, these results suggest emerging new patterns of TB transmission and a role of socioeconomic position on the risk of TB infection opposite to that expected.

Loading

Article metrics loading...

/content/journals/10.4269/ajtmh.2009.80.1004
2009-06-01
2017-09-21
Loading full text...

Full text loading...

/deliver/fulltext/14761645/80/6/0801004.html?itemId=/content/journals/10.4269/ajtmh.2009.80.1004&mimeType=html&fmt=ahah

References

  1. Dubos RJ, 1987. The White Plague: Tuberculosis, Man, and Society. Piscataway, NJ: Rutgers University Press.
  2. Bank W, 2000. World Development Indicators. Washington, DC: The World Bank.
  3. WHO, 2005. Addressing Poverty in TB Control: Options for National TB Control Programmes. Geneva: WHO.
  4. Cantwell MF, McKenna MT, McCray E, Onorato IM, 1998. Tuberculosis and race/ethnicity in the United States: impact of socioeconomic status. Am J Respir Crit Care Med 157 : 1016–1020.
  5. CDC, 1992. Prevention and control of tuberculosis in U.S. communities with at-risk minority populations. Recommendations of the Advisory Council for the Elimination of Tuberculosis. MMWR Recomm Rep 41 : 1–11.
  6. Hanson C, 2002. Tuberculosis, Poverty and Inequity: A Review of the Literature and Discussion of Issues. Washington, DC: World Bank.
  7. Kuemmerer JM, Comstock GW, 1967. Sociologic concomitants of tuberculin sensitivity. Am Rev Respir Dis 96 : 885–892.
  8. Spence DP, Hotchkiss J, Williams CS, Davies PD, 1993. Tuberculosis and poverty. BMJ 307 : 759–761.
  9. Bhatti N, Law MR, Morris JK, Halliday R, Moore-Gillon J, 1995. Increasing incidence of tuberculosis in England and Wales: a study of the likely causes. BMJ 310 : 967–969.
  10. Lienhardt C, Fielding K, Sillah J, Tunkara A, Donkor S, Manneh K, Warndorff D, McAdam KP, Bennett S, 2003. Risk factors for tuberculosis infection in sub-Saharan Africa: a contact study in The Gambia. Am J Respir Crit Care Med 168 : 448–455.
  11. Claessens NJ, Gausi FF, Meijnen S, Weismuller MM, Salaniponi FM, Harries AD, 2002. High frequency of tuberculosis in households of index TB patients. Int J Tuberc Lung Dis 6 : 266–269.
  12. Schoeman JH, Westaway MS, Neethling A, 1991. The relationship between socioeconomic factors and pulmonary tuberculosis. Int J Epidemiol 20 : 435–440.
  13. Sanchez-Perez H, Flores-Hernandez J, Jansa J, Cayla J, Martin-Mateo M, 2001. Pulmonary tuberculosis and associated factors in areas of high levels of poverty in Chiapas, Mexico. Int J Epidemiol 30 : 386–393.
  14. Glynn JR, Warndorff DK, Malema SS, Mwinuka V, Ponnighaus JM, Crampin AC, Fine PE, 2000. Tuberculosis: associations with HIV and socioeconomic status in rural Malawi. Trans R Soc Trop Med Hyg 94 : 500–503.
  15. Tekkel M, Rahu M, Loit HM, Baburin A, 2002. Risk factors for pulmonary tuberculosis in Estonia. Int J Tuberc Lung Dis 6 : 887–894.
  16. Coker R, McKee M, Atun R, Dimitrova B, Dodonova E, Kuznetsov S, Drobniewski F, 2006. Risk factors for pulmonary tuberculosis in Russia: case-control study. BMJ 232 : 85–87.
  17. Mangtani P, Jolley DJ, Watson JM, Rodrigues LC, 1995. Socioeconomic deprivation and notification rates for tuberculosis in London during 1982–91. BMJ 310 : 963–966.
  18. Farhat M, Greenaway C, Pai M, Menzies D, 2006. False-positive tuberculin skin tests: what is the absolute effect of BCG and non-tuberculous mycobacteria? Int J Tuberc Lung Dis 10 : 1192–1204.
  19. Villate JI, Ibanez B, Cabriada V, Pijoan JI, Taboada J, Urkaregi A, 2006. Analysis of latent tuberculosis and Mycobacterium avium infection data using mixture models. BMC Public Health 6 : 240.
  20. Kerr-Pontes LR, Barreto ML, Evangelista CM, Rodrigues LC, Heukelbach J, Feldmeier H, 2006. Socioeconomic, environmental, and behavioural risk factors for leprosy in North-east Brazil: results of a case-control study. Int J Epidemiol 35 : 994–1000.
  21. Kerr-Pontes LR, Montenegro AC, Barreto ML, Werneck GL, Feldmeier H, 2004. Inequality and leprosy in Northeast Brazil: an ecological study. Int J Epidemiol 33 : 262–269.
  22. Raghunathan PL, Whitney EA, Asamoa K, Stienstra Y, Taylor TH Jr, Amofah GK, Ofori-Adjei D, Dobos K, Guarner J, Martin S, Pathak S, Klutse E, Etuaful S, van der Graaf WT, van der Werf TS, King CH, Tappero JW, Ashford DA, 2005. Risk factors for Buruli ulcer disease (Mycobacterium ulcerans infection): results from a case-control study in Ghana. Clin Infect Dis 40 : 1445–1453.
  23. Engel A, Roberts J, 1977. Tuberculin skin test reaction among adults 25–74 years, United States, 1971–72. Vital Health Stat 11 204 : 1–40.
  24. Reichman LB, O’Day R, 1978. Tuberculous infection in a large urban population. Am Rev Respir Dis 117 : 705–712.
  25. Pelly TF, Santillan CF, Gilman RH, Cabrera LZ, Garcia E, Vidal C, Zimic MJ, Moore DA, Evans CA, 2005. Tuberculosis skin testing, anergy and protein malnutrition in Peru. Int J Tuberc Lung Dis 9 : 977–984.
  26. Filmer D, Pritchett LH, 2001. Estimating wealth effects without expenditure data–or tears: an application to educational enrollments in states of India. Demography 38 : 115–132.
  27. Bartholomew DJSF, Moustaki I, Galbraith JI, 2002. Principal Component Analysis: The Analysis and Interpretation of Multivariate Data for Social Scientists. Chapman & Hall/CRC, 115–142.
  28. CGAP, 2002. Assessing the Relative Poverty of Microfinance Clients: A CGAP Operational Tool. Washington, DC: CGAP.
  29. Lalvani A, 2007. Diagnosing tuberculosis infection in the 21st century: new tools to tackle an old enemy. Chest 131 : 1898–1906.
  30. Pai M, Kalantri S, Dheda K, 2006. New tools and emerging technologies for the diagnosis of tuberculosis: part I. Latent tuberculosis. Expert Rev Mol Diagn 6 : 413–422.
  31. World Health Organization, 2008. Global tuberculosis control: surveillance, planning, financing. WHO Report 2008. Geneva, Switzerland.
  32. LCMS, November 2004. Living Conditions Monitoring Survey Report, 2002–2003. Lusaka, Zambia: Central Statistical Office, Republic of Zambia.
  33. Victora CG, Huttly SR, Fuchs SC, Olinto MT, 1997. The role of conceptual frameworks in epidemiological analysis: a hierarchical approach. Int J Epidemiol 26 : 224–227.
  34. Kass EH, 1971. Infectious diseases and social change. J Infect Dis 123 : 110–114.
  35. Springett VH, 1952. An interpretation of statistical trends in tuberculosis. Lancet 1 : 575–580.
  36. Hunter JM, Thomas MO, 1984. Hypothesis of leprosy, tuberculosis and urbanization in Africa. Soc Sci Med 19 : 27–57.
  37. Enarson DA, Wang JS, Dirks JM, 1989. The incidence of active tuberculosis in a large urban area. Am J Epidemiol 129 : 1268–1276.
  38. Drucker E, Alcabes P, Bosworth W, Sckell B, 1994. Childhood tuberculosis in the Bronx, New York. Lancet 343 : 1482–1485.
  39. Acevedo-Garcia D, 2001. Zip code-level risk factors for tuberculosis: neighborhood environment and residential segregation in New Jersey, 1985–1992. Am J Public Health 91 : 734–741.
  40. Wanyeki I, Olson S, Brassard P, Menzies D, Ross N, Behr M, Schwartzman K, 2006. Dwellings, crowding, and tuberculosis in Montreal. Soc Sci Med 63 : 501–511.
  41. Klovdahl AS, Graviss EA, Yaganehdoost A, Ross MW, Wanger A, Adams GJ, Musser JM, 2001. Networks and tuberculosis: an undetected community outbreak involving public places. Soc Sci Med 52 : 681–694.
  42. McElroy PD, Rothenberg RB, Varghese R, Woodruff R, Minns GO, Muth SQ, Lambert LA, Ridzon R, 2003. A network-informed approach to investigating a tuberculosis outbreak: implications for enhancing contact investigations. Int J Tuberc Lung Dis 7 : S486–S493.
  43. Michelo C, Sandoy IF, Dzekedzeke K, Siziya S, Fylkesnes K, 2006. Steep HIV prevalence declines among young people in selected Zambian communities: population-based observations (1995–2003). BMC Public Health 6 : 279.
  44. Fylkesnes K, Musonda RM, Kasumba K, Ndhlovu Z, Mluanda F, Kaetano L, Chipaila CC, 1997. The HIV epidemic in Zambia: socio-demographic prevalence patterns and indications of trends among childbearing women. AIDS 11 : 339–345.
  45. Fylkesnes K, Musonda RM, Sichone M, Ndhlovu Z, Tembo F, Monze M, 2001. Declining HIV prevalence and risk behaviours in Zambia: evidence from surveillance and population-based surveys. AIDS 15 : 907–916.
  46. Clark M, Riben P, Nowgesic E, 2002. The association of housing density, isolation and tuberculosis in Canadian First Nations communities. Int J Epidemiol 31 : 940–945.
  47. Barker RD, Millard FJ, Malatsi J, Mkoana L, Ngoatwana T, Agarawal S, de Valliere S, 2006. Traditional healers, treatment delay, performance status and death from TB in rural South Africa. Int J Tuberc Lung Dis 10 : 670–675.
  48. Elender F, Bentham G, Langford I, 1998. Tuberculosis mortality in England and Wales during 1982–1992: its association with poverty, ethnicity and AIDS. Soc Sci Med 46 : 673–681.
  49. van Lettow M, West CE, van der Meer JW, Wieringa FT, Semba RD, 2005. Low plasma selenium concentrations, high plasma human immunodeficiency virus load and high interleukin-6 concentrations are risk factors associated with anemia in adults presenting with pulmonary tuberculosis in Zomba district, Malawi. Eur J Clin Nutr 59 : 526–532.
  50. Macallan DC, 1999. Malnutrition in tuberculosis. Diagn Microbiol Infect Dis 34 : 153–157.
  51. Rathi SK, Akhtar S, Rahbar MH, Azam SI, 2002. Prevalence and risk factors associated with tuberculin skin test positivity among household contacts of smear-positive pulnionary tuberculosis cases in Umerkot, Pakistan. Int J Tuberc Lung Dis 6 : 851–857.
  52. Lienhardt C, 2001. From exposure to disease: the role of environmental factors in susceptibility to and development of tuberculosis. Epidemiol Rev 23 : 288–301.
  53. Kenyon TA, Creek T, Laserson K, Makhoa M, Chimidza N, Mwasekaga M, Tappero J, Lockman S, Moeti T, Binkin N, 2002. Risk factors for transmission of Mycobacterium tuberculosis from HIV-infected tuberculosis patients, Botswana. Int J Tuberc Lung Dis 6 : 843–850.
  54. Tornee S, Kaewkungwal J, Fungladda W, Silachamroon U, Akarasewi P, Sunakorn P, 2004. Risk factors for tuberculosis infection among household contacts in Bangkok, Thailand. Southeast Asian J Trop Med Public Health 35 : 375–383.
  55. Singh M, Mynak ML, Kumar L, Mathew JL, Jindal SK, 2005. Prevalence and risk factors for transmission of infection among children in household contact with adults having pulmonary tuberculosis. Arch Dis Child 90 : 624–628.
  56. Sinfield R, Nyirenda M, Haves S, Molyneux EM, Graham SM, 2006. Risk factors for TB infection and disease in young childhood contacts in Malawi. Ann Trop Paediatr 26 : 205–213.
http://instance.metastore.ingenta.com/content/journals/10.4269/ajtmh.2009.80.1004
Loading
/content/journals/10.4269/ajtmh.2009.80.1004
Loading

Data & Media loading...

  • Received : 03 Oct 2008
  • Accepted : 03 Feb 2009

Most Cited This Month

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error