Crowding, mobility predict TB infection among kids

A high prevalence of tuberculosis (TB) infection is seen among children and adolescents residing in rural Uganda, a study has found. Crowding and mobility are some of the factors associated with TB risk.

The authors measured TB infection in children aged 1–17 years in 25 villages in rural Southwestern Uganda from December 2021 to June 2023. TB infection was defined as a positive QuantiFERON Gold Plus Test (QFT).

Overall and age-stratified population-level prevalence was estimated, as well as adjusted risk ratios (aRR) of TB infection for individual, household, and community-based predictors, accounting for age, TB contact, and clustering by household.

The estimated prevalence of TB infection among 5,789 participants was 9.6 percent (95 percent confidence interval [CI], 8.7–10.5), which varied slightly with age.

Predictors of TB infection in the household included crowding (aRR, 1.25, 95 percent CI, 1.03–1.53), indoor cooking (aRR, 1.62, 95 percent CI, 1.14–2.30), and living with two or more persons who drink alcohol (aRR, 1.47, 95 percent CI, 1.04–2.07). On the other hand, child morbidity was the most prevalent community-based risk factor (aRR, 1.67, 95 percent CI, 1.24–2.26).

Age-stratified analyses revealed the importance of household risk factors in early childhood and mobility in adolescence (aRR, 1.66, 95 percent CI, 1.13–2.44).

“On a population level, TB risk factors change throughout the early life course, with child mobility a key risk factor in adolescence,” the authors said. “Age-specific TB case finding and prevention strategies that address both household and extra-household risk factors are needed to address TB transmission.”