Socio-economic status and risk of tuberculosis: a case-control study of HIV-infected patients in Asia

Int J Tuberc Lung Dis. 2018 Feb 1;22(2):179-186. doi: 10.5588/ijtld.17.0348.

Abstract

Setting: 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.

Objective: To assess the socio-economic determinants of TB in HIV-infected patients in Asia.

Design: 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.

Results: 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 wood or coal regularly inside the house and living in the same place of origin were weakly associated with TB diagnosis.

Conclusions: These data suggest that lower socio-economic status is associated with an increased risk of TB in Asia. Integrating clinical and socio-economic factors into HIV treatment may help in the prevention of opportunistic infections and disease progression.

Publication types

  • Multicenter Study
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Asia / epidemiology
  • CD4 Lymphocyte Count
  • Case-Control Studies
  • Cohort Studies
  • Female
  • HIV Infections*
  • Humans
  • Male
  • Middle Aged
  • Prospective Studies
  • Risk Factors
  • Socioeconomic Factors
  • Surveys and Questionnaires
  • Tuberculosis, Pulmonary / complications
  • Tuberculosis, Pulmonary / epidemiology*
  • Urban Population