The effect of household poverty on tuberculosis
To assess the relationship between household socio-economic level, relative and absolute, and individual TB disease
Abstract
Setting
Households in Malawi, Mongolia, Myanmar, the Philippines, Rwanda, Tanzania, Viet Nam and Zambia.
Objective
To assess the relationship between household socio-economic level, both relative and absolute, and individual tuberculosis (TB) disease.
Design
We analysed national TB prevalence surveys from eight countries individually and in pooled multicountry models. Socio-economic level (SEL) was measured in terms of both relative household position and absolute wealth. The outcome of interest was whether or not an individual had TB disease. Logistic regression models were used to control for putative risk factors for TB disease such as age, sex and previous treatment history.
Results
Overall, a strong and consistent association between household SEL and individual TB disease was not found. Significant results were found in four individual country models, with the lowest socio-economic quintile being associated with higher TB risk in Mongolia, Myanmar, Tanzania and Viet Nam.
Conclusions
TB prevalence surveys are designed to assess prevalence of disease and, due to the small numbers of cases usually detected, may not be the most efficient means of investigating TB risk factors. Different designs are needed, including measuring the SEL of individuals in nested case-control studies within TB prevalence surveys or among TB patients seeking treatment in health care facilities.
This research was supported by the UK Department for International Development’s Operational Research Capacity Building Programme led by the International Union Against TB and Lung Disease (The Union)
Citation
Siroka A, Law I, Macinko J, Floyd K, Banda RP, Hoa NB, Tsolmon B, Chanda-Kapata P, Gasana M, Lwinn T, Senkoro M, Tupasi T, Ponce NA.(2015) The effect of household poverty on tuberculosis. The International Journal of Tuberculosis and Lung Disease, Volume 20, Number 12, 1 December 2016, pp. 1603-1608(6) DOI: https://doi.org/10.5588/ijtld.16.0386