Prevalence and Risk Factors for Mycobacterium tuberculosis Infection Among Adolescents in Rural South Africa. (11th November 2020)

• Record Type: Journal Article
• Authors: Mzembe, Themba; Lessells, Richard; Karat, Aaron S; Randera-Rees, Safiyya; Edwards, Anita; Khan, Palwasha; Tomita, Andrew; Tanser, Frank; Baisley, Kathy; Grant, Alison D
• Is Part Of: Open forum infectious diseases. Volume 8:Number 1(2021)
• Publication Date: 2020-11-11
• Subjects: IGRA -- latent Mycobacterium tuberculosis infection -- risk factors; Communicable diseases -- Periodicals; Medical microbiology -- Periodicals; Infection -- Periodicals; 616.9
• DOI: 10.1093/ofid/ofaa520
• Languages: English
• ISSNs: 2328-8957

Abstract

Abstract: Background: We aimed to estimate the prevalence of and explore risk factors for Mycobacterium tuberculosis infection among adolescents in a high tuberculosis (TB) and human immunodeficiency virus (HIV) prevalence setting. Methods: A cross-sectional study of adolescents (10–19 years) randomly selected from a demographic surveillance area (DSA) in rural KwaZulu-Natal, South Africa. We determined M tuberculosis infection status using the QuantiFERON-TB Gold-plus assay. We used HIV data from the DSA to estimate community-level adult HIV prevalence and random-effects logistic regression to identify risk factors for TB infection. Results: We enrolled 1094 adolescents (548 [50.1%] female); M tuberculosis infection prevalence (weighted for nonresponse by age, sex, and urban/rural residence) was 23.0% (95% confidence interval [CI], 20.6–25.6%). Mycobacterium tuberculosis infection was associated with older age (adjusted odds ratio [aOR], 1.37; 95% CI, 1.10–1.71, for increasing age-group [12–14, 15–17, and 18–19 vs 10–11 years]), ever (vs never) having a household TB contact (aOR, 2.13; 95% CI, 1.25–3.64), and increasing community-level HIV prevalence (aOR, 1.43 and 95% CI, 1.07–1.92, for increasing HIV prevalence category [25%–34.9%, 35%–44.9%, ≥45% vs <25%]). Conclusions: Our data support prioritizing TB prevention and care activities in TB-affected households and high HIV prevalence communities. Abstract : Mycobacterium tuberculosis infection prevalence among adolescents (aged 10–19 years) in rural KwaZulu-Natal, South Africa was 23.0%; and was associated with increased community-level HIV prevalence, increasing age and lifetime household TB contact.