Abstract
ObjectivesThe aim of this study was to determine factors associated with active pulmonary tuberculosis seen in cases in Ambo Hospital, Ethiopia.DesignA facility-based prospective case-control study.SettingPatients attending Ambo Hospital from 01 December 2011 to 29 March 2012.ParticipantsThe sample included 312 adult patients attending Ambo Hospital. The main outcome measure was presence of active pulmonary tuberculosis (TB).Explanatory measuresAge, gender, occupation, educational status, marital status, place of residence, patient history of TB, family history of TB, human immunodeficiency virus (HIV) infection, smoking, alcohol intake, khat chewing, body mass index (BMI), employment, diabetes, history of asthma, previous history of worm infestation, history of hospitalisation, number of adults living in the household (HH), person per room, housing condition.ResultsA total of 312 study participants, including 104 active pulmonary tuberculosis (PTB) cases (cases) and 208 non-active PTB cases (controls), were recruited for the present study. Having one or more family member with a history of TB (OR = 4.4; 95% CI: 1.50–12.90), marital status (OR = 7.6; 95% CI: 2.2–12.6), male gender (OR = 3.2; 95% CI: 1.4–7), rural residence (OR = 3.3; P = 0.012), being a current or past smoker (OR = 2.8; 95% CI: 1.1–7.2), BMI < 18.5 (OR = 2.1; 95% CI: 1.03–4.2), HIV infection (OR = 8.8; 95% CI: 2.4–23.8) and a history of worm infestation (OR = 6.4; 95% CI: 2.6–15.4) remained significant independent host-related factors for active PTB.ConclusionPatients who came from a compound with more than two HHs were more likely to develop active PTB than those who came from a compound with only one HH. Those who lived in houses with no windows were more likely to develop active PTB than those who lived in houses with one or more windows, had a family history of TB, lived in rural areas. Sex of the patient was a predicting factor. Not being the owner of the house was significantly more associated with active PTB. Measures taken to reduce the prevalence and burden of active PTB should consider these determinant factors.
Highlights
IntroductionThe causal agent is the tubercle bacillus Mycobacterium tuberculosis, and sometimes Mycobacterium bovis or Mycobacterium africanum.[1,2] The most common form of disease, caused by M. tuberculosis, is pulmonary tuberculosis (PTB)
Tuberculosis (TB) is an airborne bacterial disease
In the combined multivariate analysis of host- and environment-related factors, patients who lived in houses with more than one HH in the compound were significantly more likely to develop active pulmonary tuberculosis (PTB) than with those who lived in HHs with only one house in the compound
Summary
The causal agent is the tubercle bacillus Mycobacterium tuberculosis, and sometimes Mycobacterium bovis or Mycobacterium africanum.[1,2] The most common form of disease, caused by M. tuberculosis, is pulmonary tuberculosis (PTB). The pulmonary form of TB is infectious because it is transmitted through aerosol whenever individuals with active PTB cough, sneeze, talk or laugh, and droplets in the air are inhaled by those who are in close contact with the infectious case.[3,4,5,6]. TB represents one third of the world’s health problems; roughly two billion people are affected.[7,8] Annually, an estimated eight to ten million people develop TB owing to primary infection, reactivation or re-infection.[8] In 2009, there were an estimated 9.4 million new cases, 14 million existing cases and 1.68 million deaths from TB. Most cases were in the South-East Asia, African and Western Pacific regions (35%, 30% and 20%, respectively).[7,9] Ninetyfive per cent of TB cases in low-income countries are amongst people between 15 and 50 years old.[10,11]
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