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Abstract
BackgroundThe objectives of this study were to assess the tuberculosis (TB) burden and to provide an insight into the type of circulating M. tuberculosis species in urban slums of Bangladesh. We also aimed to test the feasibility of a larger transmission study in this setting.MethodsThis cross-sectional study was conducted in an urban slum of Dhaka city. The household members were actively screened to assess the presence of TB-related signs and symptoms; cough ≥3 weeks and body mass index (BMI) <17 kg/m2. Sputum specimens from suspects were collected for acid fast bacilli (AFB) microscopy, culture and drug susceptibility testing. Genotyping of M. tuberculosis was done using spoligotyping and variable number tandem repeats of mycobacterial interspersed repetitive units typing.ResultsAmong 9,877 adult screened for pulmonary TB (PTB), 25 were positive for AFB on microscopy and/or culture and the prevalence of new PTB cases was estimated to be 253/100,000. Only one child TB case was diagnosed among 5,147 child screened. Out of 26 cases, 21(81%) had cough for several duration and 5(19%) did not present with cough at the time of screening. One multidrug resistant case was found. Fifty two percent of all TB cases had BMI <17 kg/m2 (p = <0.001). Among the 20 analyzed isolates, 13 different spoligotype patterns were identified in which 5 clusters contained 12 strains and 8 strains had unique pattern.ConclusionsThe study revealed high prevalence of TB in urban slums. Screening using low BMI can be beneficial among risk group population. It is important to conduct larger study to validate clinical variables like cough <3 weeks and low BMI to define TB suspect and also to investigate the transmission of TB in slum settings.
Highlights
The global burden of tuberculosis (TB) in 2010 is estimated to be 8.8 million in the form of incident cases, 12 million in the form of prevalent cases [1]
Majority (87%) of these suspects who were unable to provide sputum specimen were initially identified as a suspect because of their low body mass index (BMI) even in the absence of cough for any duration
The estimated number of new pulmonary TB cases (AFB and/or culture) was 253/100,000 population and the estimated number of new SS+ TB cases was 192/100,000 populations; among the subjects aged $15 years, who participated in the study
Summary
The global burden of tuberculosis (TB) in 2010 is estimated to be 8.8 million in the form of incident cases, 12 million in the form of prevalent cases [1]. The incidence is estimated indirectly through notification of passively detected patients. The real burden of TB could be markedly higher if active case finding would be employed on larger scale than is often done. Differences in TB incidence between urban and rural areas have been described [2]. The objectives of this study were to assess the tuberculosis (TB) burden and to provide an insight into the type of circulating M. tuberculosis species in urban slums of Bangladesh. We aimed to test the feasibility of a larger transmission study in this setting
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