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Risk factors for M. tuberculosis infection in vitamin D deficient Mongolian school children
Author(s) -
Ganmaa Davaasambuu,
Khudyakov Polyna,
Munkhjargal Oyunsuren,
Jargalsaikhan Badamtsetseg,
Baigal Delgereh,
Ochirbat Batbayar,
Buyanjargal Uyanga,
Martineau Adrian
Publication year - 2017
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.31.1_supplement.786.24
Subject(s) - medicine , tuberculosis , relative risk , confidence interval , incidence (geometry) , population , interferon gamma release assay , demography , mycobacterium tuberculosis , environmental health , latent tuberculosis , physics , pathology , sociology , optics
Mongolia has one of the highest TB incidence rates in the Asia Pacific Region (170 per 100,000 population per year estimated in 2014). Schoolchildren are at high risk of acquiring M. tuberculosis infection. However, the prevalence of M. tuberculosis infection and risk factors for acquiring it have not previously been investigated in this setting. Methods We screened children aged 6–13 years attending 15 public schools in Ulaanbaatar, Mongolia, for M. tuberculosis infection using a commercial Interferon‐Gamma Release Assay (QuantiFERON‐TB Gold in‐tube assay, QFT‐G). Information on risk factors for acquisition of Mtb infection was collected from study participants. Regression analysis was conducted to identify independent risk factors for QFT‐G positivity. Results The QFT‐G test was performed on a total of 9,137 participants from September 2015 to May 2016: of these, 908 (9.9%) had a positive result, 8,225 (90.0%) had a negative result and 4 (<0.1%) had an indeterminate result. QFT‐positivity was independently associated with increasing age [relative risk (RR) associated with each additional year of age, 1.15, 95% confidence interval (CI)1.11 to 1.29)], exposure to cigarette smoke in the home [RR=1.21, 95% CI1.07 to 1.36], presence of a case of active TB in the home [RR=4.01, 95% CI 3.45–4.67] and season of enrolment (Winter vs. Autumn, RR 1.19, 95% CI 1.01 to 1.41; Spring vs. Autumn, RR=1.30, 95% CI 1.10–1.55]. Among the sub‐set of 327 children with a history of household exposure to a case of active TB, QFT‐G positivity was independently associated with increasing age (RR associated with each additional year of age 1.10, 95% CI 1.01 to 1.19) and number of index cases to whom they had been exposed (RR 1.72, 95% CI 1.37 to 2.17). Conclusions The prevalence of M. tuberculosis infection was 10%. Risk of infection was independently associated with household exposure to an infectious index case, increasing age, passive smoking and sampling in Winter or Spring Support or Funding Information NIH/NHLBI 1R01HL122624‐01