Abstract
Background
We aimed to estimate the prevalence of and explore risk factors for Mycobacterium tuberculosis infection among adolescents in a high tuberculosis (TB) and HIV prevalence setting.
Methods
A cross-sectional study of adolescents (10–19 years) randomly selected from a demographic surveillance area (DSA) in rural KwaZulu-Natal, South Africa. We determined M. tuberculosis infection status using the QuantiFERON-TB Gold-plus assay. We used HIV data from the DSA to estimate community-level adult HIV prevalence and random effects logistic regression to identify risk factors for TB infection.
Results
We enrolled 1,094 adolescents (548 [50.1%] female); M. tuberculosis infection prevalence (weighted for non-response by age, sex, and urban/rural residence) was 23.0% (95% confidence interval [CI]: 20.6–25.6%). M. tuberculosis infection was associated with older age (adjusted odds ratio [aOR]: 1.37; 95% CI: 1.10–1.71, for increasing age-group [12–14, 15–17, 18–19 vs. 10–11 years]), ever (vs. never) having a household TB contact (aOR: 2.13, 95% CI: 1.25–3.64) and increasing community-level HIV prevalence (aOR: 1.43, 95% CI: 1.07–1.92, for increasing HIV prevalence category [25–34.9%, 35–44.9%, ≥45% vs. <25%]).
Conclusion
Our data support prioritising TB prevention and care activities in TB-affected households and high HIV prevalence communities.
Risk factoRs of mycobacteRium tubeRculosis infection in childRen living in RuRal aReas