Risk Factors for Tuberculosis (TB) Among Household Contacts of Patients With Smear-Positive TB in 8 Provinces of Vietnam: A Nested Case-Control Study

Author:

Velen Kavindhran12ORCID,Nhung Nguyen Viet3,Anh Nguyen Thu2,Cuong Pham Duc2,Hoa Nguyen Binh34,Cuong Nguyen Kim35,Dung Nguyen Huy6,Sy Dinh Ngoc3,Britton Warwick John78,Marks Guy Barrington29,Fox Greg James12

Affiliation:

1. Sydney Medical School, The University of Sydney, Sydney, Australia

2. Woolcock Institute of Medical Research, Sydney, Australia

3. National Lung Hospital, Hanoi, Vietnam

4. Center for Operational Research, International Union Against Tuberculosis and Lung Disease, Paris, France

5. Hanoi Medical University, Hanoi, Vietnam

6. Pham Ngoc Thach Hospital, Ho Chi Minh City, Vietnam

7. Centenary Institute of Cancer Medicine and Cell Biology, University of Sydney, Sydney, Australia

8. Department of Clinical Immunology, Royal Prince Alfred Hospital, Sydney, Australia

9. South Western Sydney Clinical School, University of New South Wales, Sydney, Australia

Abstract

Abstract Background Tuberculosis (TB) continues to account for significant morbidity and mortality annually. Household contacts (HHCs) of persons with TB are a key population for targeting prevention and control interventions. We aimed to identify risk factors associated with developing TB among HHCs. Methods We conducted a nested case-control study among HHCs in 8 provinces in Vietnam enrolled in a randomized controlled trial of active case finding for TB. Cases were any HHCs diagnosed and registered with TB within the Vietnam National TB Program during 2 years of follow-up. Controls were selected by simple random sampling from the remaining HHCs. Risk factor data were collected at enrollment and during follow-up. A logistic regression model was developed to determine predictors of TB among HHCs. Results We selected 1254 HHCs for the analysis: 214 cases and 1040 controls. Underlying characteristics varied between both groups; cases were older, more likely to be male, with a higher proportion of reported previous TB and diabetes. Risk factors associated with a TB diagnosis included being male (adjusted odds ratio [aOR], 1.4; 95% confidence interval [CI], 1.03–2.0), residing in an urban setting (aOR, 1.8; 1.3–2.5), prior TB (aOR, 4.6; 2.5–8.7), history of diabetes (aOR, 3.1; 1.7–5.8), current smoking (aOR, 3.1; 2.2–4.4), and prolonged history of coughing in the index case at enrollment (OR , 1.6; 1.1–2.3). Conclusions Household contacts remain an important key population for TB prevention and control. TB programs should ensure effective contact investigations are implemented for household contacts, particularly those with additional risk factors for developing TB.

Publisher

Oxford University Press (OUP)

Subject

Infectious Diseases,Microbiology (medical)

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