Identifying risk factors associated with smear positivity of pulmonary tuberculosis in Kazakhstan
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Date
2017-03-01
Authors
Hermosilla, Sabrina
You, Paul
Aifah, Angela
Abildayev, Tleukhan
Akilzhanova, Ainur
Kozhamkulov, Ulan
Muminov, Talgat
Darisheva, Meruert
Zhussupov, Baurzhan
Terlikbayeva, Assel
Journal Title
Journal ISSN
Volume Title
Publisher
PLoS ONE
Abstract
Background
Sputum smear-positive tuberculosis (TB) patients have a high risk of transmission and are of great epidemiological and infection control significance. Little is known about the smearpositive populations in high TB burden regions, such as Kazakhstan. The objective of this study is to characterize the smear-positive population in Kazakhstan and identify associated modifiable risk factors. Methods Data on incident TB cases' (identified between April 2012 and March 2014) socio-demographic, risk behavior, and comorbidity characteristics were collected in four regions of Kazakhstan through structured survey and medical record review. We used multivariable logistic regression to determine factors associated with smear positivity. Results Of the total sample, 193 (34.3%) of the 562 study participants tested smear-positive. In the final adjusted multivariable logistic regression model, sex (adjusted odds ratio (aOR) = 2.0, 95% CI:1.3±3.1, p < 0.01), incarceration (aOR = 3.6, 95% CI:1.2±11.1, p = 0.03), alcohol
dependence (aOR = 2.6, 95% CI:1.2±5.7, p = 0.02), diabetes (aOR = 5.0, 95% CI:2.4±10.7, p < 0.01), and physician access (aOR = 2.7, 95% CI:1.3±5.5p < 0.01) were associated with smear-positivity. Conclusions Incarceration, alcohol dependence, diabetes, and physician access are associated with smear positivity among incident TB cases in Kazakhstan. To stem the TB epidemic, screening, treatment and prevention policies should address these factors.
Description
Keywords
pulmonary tuberculosis, sputum smear-positive tuberculosis, Kazakhstan
Citation
Hermosilla Sabrina et al.(>11), 2017(March 1), Identifying risk factors associated with smear positivity of pulmonary tuberculosis in Kazakhstan, PLoS ONE,