Identifying risk factors associated with smear positivity of pulmonary TB in Kazakhstan
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 smear-positive 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.
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Source:
PLOS ONE
