Prevalence of tuberculosis (TB), including multi-drug-resistant and extensively-drug-resistant TB, and association with occupation in adults at Sirindhorn Hospital, Bangkok

Abstract

Tuberculosis (TB) affects both child and adult populations worldwide. This retrospective study was conducted to survey the prevalence of TB and its association with patient occupation in an adult population diagnosed with TB at Sirindhorn Hospital in 2018. Data were extracted from the medical records of 186 patients with TB, and prevalence and odds ratios were calculated. Pulmonary (83.3%) and extrapulmonary TB (17.7%) were observed among the cases. Overall, 70.4% of cases were male and 29.6% were female. Mono-drug-resistant TB, multi-drug-resistant TB and extensively-drug-resistant TB were observed in 2.72%, 4.1% and 0.68% of cases, respectively. Although not statistically significant, individuals with comorbidities had a 2.16-fold [95% confidence interval (CI) 0.33-13.98] higher risk of TB compared with those without comorbidities. Unemployed patients with TB were 4-fold (95% CI 0.82-19.42) more likely to have hypertension than employed patients or traders. The risk of TB among patients with human immunodeficiency virus (HIV) infection was 2.22-fold (95% CI 0.93-5.31) higher among females compared with males, and relapsed patients had a 0.92-fold (95% CI 0.19-4.47) lower risk of HIV infection as a comorbidity compared with new TB cases. Patient occupation could play a role in the prevalence of TB among communities. The highest prevalence of TB was observed among unemployed subjects, and unemployed patients with TB were more likely to have hypertension as a comorbidity. Mapping the zones/areas of residence for patients with TB could assist in identifying TB hot spots, and could improve understanding of the drivers of the high TB burden and associated socio-economic factors. More studies are required to further understand the drivers that are leading to the high TB burden and the risks posed by occupations.