Investigation of the risk factors for tuberculosis: a case-control study in three countries in West Africa

被引:159
作者
Lienhardt, C
Fielding, K
Sillah, JS
Bah, B
Gustafson, P
Warndorff, D
Palayew, M
Lisse, I
Donkor, S
Diallo, S
Manneh, K
Adegbola, R
Aaby, P
Bah-Sow, O
Bennett, S
McAdam, K
机构
[1] Inst Rech Dev, Dakar, Senegal
[2] MRC Labs, Fajara, Gambia
[3] London Sch Hyg & Trop Med, London WC1, England
[4] CHU Ignace Deen, Programme Natl Lutte AntiTuberculeuse, Serv Pneumol, Conakry, Guinea
[5] Danish Epidemiol Sci Ctr, Projecto Saude Bandim, Bissau, Guinea Bissau
[6] McGill Univ, Jewish Gen Hosp, Div Pulm Med, Montreal, PQ H3A 2T5, Canada
基金
英国医学研究理事会;
关键词
tuberculosis; risk factors; epidemiology; developing countries;
D O I
10.1093/ije/dyi100
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
Background Host-related and environment-related factors have been shown to play a role in the development of tuberculosis (TB), but few studies were carried out to identify their respective roles in resource-poor countries. Methods A multicentre case-control study was conducted in Guinee, Guinea Bissau, and The Gambia, from January 1999 to March 2001. Cases were newly detected smear positive TB patients. TWO controls were recruited for each case, one within the household of the case, and one in the community. Results Regarding host-related factors, univariate analysis by conditional logistic regression of 687 matched pairs of cases and household controls showed that TB was associated with male sex, family history of TB, absence of a BCG scar, smoking, alcohol, anaemia, HIV infection, and history and treatment of worm infection. In a multivariable model based on 601 matched pairs, male sex, family history of TB, smoking, and HIV infection were independent risk factors of TB. The investigation of environmental factors based on the comparison of 816 cases/community control pairs showed that the risk of TB was associated with single marital status, family history of TB, adult crowding, and renting the house. In a final model assessing the combined effect of host and environmental factors, TB was associated with male sex, HIV infection, smoking (with a dose-effect relationship), history of asthma, family history of TB, marital status, adult crowding, and renting the house. Conclusion TB is a multifactorial disorder, in which environment interacts with host-related factors. This study provided useful information for the assessment of host and environmental factors of TB for the improvement of TB control activities in developing countries.
引用
收藏
页码:914 / 923
页数:10
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