Role of risk factors and socio-economic status in pulmonary tuberculosis: a search for the root cause in patients in a tertiary care hospital, South India (original) (raw)
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Tuberculosis (TB) has reached epidemic proportions in many developing countries including India. India has more new TB cases annually than any other country with a contribution of over twenty percent to the global burden of TB.Among different types, pulmonary TB is one of the leading causes of adult mortality Studies also demonstrated that the prevalence of TB was more common among men than women of economically productive age groups, indicating variation in infection and progression of disease. Study shows that HIV positive individuals are more susceptible to develop TB compared to HIV negative individuals and it is the leading cause of death among HIV positive individuals.The association of pulmonary TB with diabetes mellitus and rheumatoid arthritis is also well established. Study also shows that TB patients had a significantly higher risk of developing chronic kidney disease than the controls. Since the introduction of National Tuberculosis Control Programme (NTP) in 1962, the Government of India has taken different steps to controlling TB on a mass basis.However, the lack of awareness regarding TB impeding progress toward TB control. Because, the incidence of TB was inversely associated with increasing awareness.Moreover, lack of awareness can worsen the epidemiological situation by
Social determinants of tuberculosis: context, framework, and the way forward to ending TB in India
Expert Review of Respiratory Medicine, 2020
Introduction Social determinants are involved in the causation of TB and its adverse outcomes. This review was conducted to evolve a framework for action on social determinants with special reference to India in the context of the new END TB strategy. Areas covered We reviewed the social context of TB in India as a neglected disease of the poor, its emergence in epidemic form in the colonial period, and the factors that resulted in its perpetuation and expansion in post-independence India. We examined the role of social determinants in two key pathways – the pathway of TB causation and its outcomes, and the care cascade for patients with TB, and its consequences. We reviewed the most important social determinants of TB including poverty, membership of certain castes and indigenous population, undernutrition and poor access to healthcare, especially in rural areas. Expert opinion We suggest that TB elimination will require an optimal mix of enhanced biomedical and social intervention...
Multidisciplinary Respiratory Medicine
Background: Tuberculosis (TB) is a major global health problem, commonly seen in underdeveloped countries. The probability of contracting the disease is significantly higher among the economically vulnerable and the socially disadvantaged. Risk factors associated with TB can also change over time. In the Sri Lankan context, no study has explored how these factors impact patients. Therefore, we aimed to explore social status, associated risk factors and lifestyle changes during the treatment period of TB patients attending a tertiary respiratory center in Colombo, Sri Lanka. Methods: The descriptive cross-sectional study was conducted in 2011. The study population consisted of diagnosed tuberculosis patients above the age of 15 years. Patient records were retrieved from the TB patient registry for the Colombo district. Systematic sampling was used to identify patients to be invited to the study. An interviewer-administered questionnaire was used for data collection. Data were collected on social status (example, level of education, employment, and income), associated risk factors (example, smoking and alcohol consumption, contact history, narcotic drug use) and lifestyle changes during treatment (example, employment status, social interactions). The analysis included a logistic regression model to explore the association between social status and risk factors. Results: The total number of patients included in the study was 425. Tuberculosis was found to be strongly prevalent among participants from the lower socioeconomic status. It was also common in participants with a low level of education, unemployed, if employed, those who are engaged in unskilled employment and have low levels of income. Risk factors associated with the patients were smoking, alcohol consumptions, narcotic drug use, imprisonment, close contact history with active TB patients and chronic medical conditions. Changes in employment and the reduction of social-interactions were the main lifestyle changes of the participants occurred during the treatment period. The analysis also showed positive correlation between low-level social status and sputum smear infectivity, and use of dangerous drugs. Even after adjusting for confounders, tuberculosis negatively affected social interactions and income levels of participants from the low social status. Conclusion: Low socioeconomic status negatively affected the lifestyle and social interactions of patients during the treatment period. Though competent treatment programs exist in Sri Lanka, it is still important to identify and mitigate risk factors associated with tuberculosis patients. A comprehensive multidisciplinary approach considering patient lifestyle, and the implications of the disease and treatment on social interactions may strengthen the current preventive strategies.
The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease, 2018
Tuberculosis (TB) is the most common human immunodeficiency virus (HIV) related opportunistic infection and cause of acquired immune-deficiency syndrome related death. TB often affects those from a low socio-economic background. To assess the socio-economic determinants of TB in HIV-infected patients in Asia. This was a matched case-control study. HIV-positive, TB-positive cases were matched to HIV-positive, TB-negative controls according to age, sex and CD4 cell count. A socio-economic questionnaire comprising 23 questions, including education level, employment, housing and substance use, was distributed. Socio-economic risk factors for TB were analysed using conditional logistic regression analysis. A total of 340 patients (170 matched pairs) were recruited, with 262 (77.1%) matched for all three criteria. Pulmonary TB was the predominant type (n = 115, 67.6%). The main risk factor for TB was not having a university level education (OR 4.45, 95%CI 1.50-13.17, P = 0.007). Burning w...
2012
This study describes the distribution of tuberculosis cases in the city of Faisalabad and the socioeconomic status of TB patients. A sample size of 165 TB patients was selected and the data is collected through questionnaires. It was observed that the highest burden of tuberculosis disease has been found in Iqbal Town and Madina Town. More than 80% patients belong to age cohort 15-64 which is actually the most significant and productive demographically as well as economically and socially. Most of the TB patients being surveyed were found to be living in extreme poverty. There were 80% patients having their total family income of Rs.10,000 per month. To understand this situation internationally, we may say that, they have total family income of USD 110 per month from all the sources. Majority of the patients are illiterate due to which they are not aware of proper treatment and precautionary measures. Poor diet, and the stress caused by the fear of isolation and long term treatment are being faced by TB patients.
African Health Sciences
Aim: To study and analyse the socio-demographic profile and basic risk factors of tuberculosis(TB) patients and their relationwith the current epidemiological status of TB registered under the RNTEP program in the study area. Subjects and Methods: This prospective study was conducted on 1743 newly registered tuberculosis patients at TB-DOT centerof South 24 Parganas, West Bengal, India from 2011-2014. Socio-demographic variables and baseline characteristics of theparticipants were noted by a semi-structured questionnaire. Results: Our study results indicate that more than 95% of the TB patients were from lower socioeconomic class, and hadpoor literacy status and tuberculosis was observed highest in non-agricultural labour and cultivators. Among the young adult’smajority of the affected population were females from the lower/upper-lower socioeconomic class. Our analysis revealed that,in successful tuberculosis therapy, men were more defaulters than women. Conclusion: Our study provid...
A profile study of tuberculosis patients in Gwalior, Madhya Pradesh
Innovative Publication, 2017
Background: Substantial progress has been made in reducing tuberculosis incidence over the past two decades. However, Tuberculosis (TB) continues to be one of the most devastating and widespread infections in the world, if left untreated, each person with active TB disease will infect on an average between 10 and 15 people every year. So to understand these factors study was carried out about socio-demographic profile of patients attending DOTS center. Methodology: The study was conducted in 3 Tuberculosis units of Gwalior city from July 2016 to Oct 2016. Patients diagnosed as having TB and registered under RNTCP were included in the study. Total patients 550 were included in the study. Results: Most of the patients coming to the RNTCP centers belong to the underprivileged group in the age group of 16 to 30 years, (40.2%), male to female ratio was observed to be 1:0.5. Majority of the patients lived in nuclear families (68.3%), belonged to low socioeconomic status (77.2%) and dwelled in overcrowded houses (71.6%). 6.9% reported history of contact with tuberculosis patients. More than half of the patients (58.5%) were undernourished. In the study, 55.5% had pulmonary TB and 44.5% had extra-pulmonary TB. HIV co-infection was prevailing in 15 patients and smoking and alcohol intake was present in 72.5% and 2% respectively and it was found statistically significant.(P<0.05). Conclusion: An improvement in living conditions, education, socioeconomic status and sanitation is desirable to curtail down the prevalence of tuberculosis.
Public Health Action, 2013
Setting: Two tertiary care hospitals and 12 peripheral health institutions (PHIs) in Trivandrum, Kerala, India. Objective: To determine factors associated with the prevalence of diabetes mellitus (DM) among tuberculosis (TB) patients and examine differences in the proportion of new DM cases among TB patients diagnosed at tertiary care centres and PHIs. Design: A descriptive study: TB patients diagnosed during March-September 2012 were screened for known DM. Those with unknown DM status were tested for random blood glucose and fasting blood glucose (FBG); FBG ⩾ 126 mg/dl was diagnosed as new DM. Results: Of 920 TB patients, 689 (72%) were male and the mean (standard deviation) age was 47.6 (16.4) years. Of these, 298 (32.4%) were diabetic: 235 (26%) had previously known DM and 63 (7%) were newly diagnosed. During the screening at PHIs and tertiary care hospitals, respectively 30/183 (16.4%) and 33/737 (4.5%) were newly diagnosed with DM (OR 3.71; 95%CI 2.17-6.32). Overall, age >50 years and pulmonary tuberculosis were independently associated with a higher prevalence of diabetes. Conclusion: As nearly one in three TB patients had DM, we recommend that TB patients should be routinely screened for DM in Kerala. As the proportion of new DM was higher among TB patients diagnosed at PHIs, we would recommend that specific attention and investment be directed to PHIs. AFFILIATIONS * Adjusted for age, sex, type of TB, smoking status and site of diagnosis. † P < 0.05. DM = diabetes mellitus; TB = tuberculosis; OR = odds ratio; CI = confidence interval; PHI = peripheral health institution.
IOSR Journal of Dental and Medical Sciences
Background: Tuberculosis remain a worldwide public health problem despite the fact that the causative organism was discovered more than 100 years ago and highly effective drugs and vaccine available making tuberculosis a preventable and curative disease. India is highest tuberculosis burden country in the world in the term of absolute number of incident cases that occurs each year. Aims and objectives-To study sociodemographic profile of pulmonary tuberculosis patients attending DOTS centre. Material and method: A cross-sectional, descriptive and community based study was conducted at field practice area(Kanke Block) of RIMS, Ranchi. A total of 300 patients of age group 14 years and above were included in the study. Pre tested, semi structured questionnaire were used for data collection. Data were entered in MS excel and analysed in spss software. Results: Out of 300 patient's majority were male (70%), between age group of 15-25 years (27.7%), Hindu (42.7%), nontribal (52%), from rural area (83.7%), educated upto secondary (33.3%), self employed (22.7%), married (56.3%), having joint family (60.3%), belonged to class IV socio economic status (B G Prasad) (58.7%). Conclusion: An overall improvement in living condition, education, socioeconomic status and sanitation is necessary to decrease the prevalence of tuberculosis.
Socio-Demographic Determinants of Adult Tuberculosis: A Matched Case-Control Study in Bangladesh
American Journal of Infectious Diseases, 2017
Tuberculosis (TB) is a multi-systemic infectious disease that has evoked a substantial disease burden in developing countries, including Bangladesh. The aim of this study is to determine the socio-demographic risk factors for adult tuberculosis. A matched case-control study was conducted with 178 cases and 179 controls from a selected TB hospital in Dhaka. Data was collected via face-to-face interview using a standard structured questionnaire, posing questions about socio-demographic, clinical and behavioral factors where tuberculosis patients were matched for age and sex to controls. Crude and multivariate logistic regression analyses were used to analyze the data. The multivariate logistic regression analysis indicated that overcrowding in a house (OR = 3.49, CI = 2.08-5.93), contact with TB patients during the last 6 months (OR = 1.789, CI = 0.917-3.559) and employed participants (OR = 1.99, CI = 1.175-3.458) were positively associated with the development of TB. Besides, monthly income (>25000 taka) (OR = 0.291, CI = 0.151-0.547) and urban living (OR = 0.295, CI = 0.163-0.527) are found negatively associated with the TB status. The identified determinants for the development of adult tuberculosis reflect a complex interaction among socio-demographic conditions. Tuberculosis control would benefit from a collaboration of broad public health activities in improving the sociodemographic factors.