OBJECTIVE: To assess mortality related to exposure to tuberculosis (TB) at home among children in urban areas of Guinea-Bissau. METHODS: In four suburban areas included in the demographic surveillance system of the Bandim Health Project in Bissau, the mortality of children aged <5 years living with an adult with TB was compared with the mortality of children in the general population. RESULTS: Children <5 years of age exposed to an adult with intrathoracic TB had 66% higher mortality than unexposed children (HR 1.66, 95% CI 1.2 to 2.3). The risk was higher for children living in the same family as a TB case (HR 2.15, 95% CI 1.3 to 3.7) than for children living in the same house but not belonging to the same family as the TB case (HR 1.51, 95% CI 1.0 to 2.2). For children whose mother had TB, mortality was increased eightfold (HR 7.82, 95% CI 2.1 to 30). The risk of death was particularly increased from 6 months following exposure (HR 2.16, 95% CI 1.5 to 3.2) and the highest rate of excess mortality was found in children aged 3–4 years. Excess mortality was highest among children with close contact with an adult with sputum-positive pulmonary TB (HR 1.90, 95% CI 1.1 to 3.2), but contact with a sputum-negative case was also associated with increased mortality (HR 1.55, 95% CI 1.0 to 2.3). Adjusting for potential confounding factors did not change these results. The mortality among children living in the same houses 3 years earlier was not increased (HR 0.90, 95% CI 0.6 to 1.3). CONCLUSION: Intimate family contact with a TB case represents a significant risk factor for child mortality in a low-income country.
OBJECTIVE: To assess mortality related to exposure to tuberculosis (TB) at home among children in urban areas of Guinea-Bissau. METHODS: In four suburban areas included in the demographic surveillance system of the Bandim Health Project in Bissau, the mortality of children aged <5 years living with an adult with TB was compared with the mortality of children in the general population. RESULTS:Children <5 years of age exposed to an adult with intrathoracic TB had 66% higher mortality than unexposed children (HR 1.66, 95% CI 1.2 to 2.3). The risk was higher for children living in the same family as a TB case (HR 2.15, 95% CI 1.3 to 3.7) than for children living in the same house but not belonging to the same family as the TB case (HR 1.51, 95% CI 1.0 to 2.2). For children whose mother had TB, mortality was increased eightfold (HR 7.82, 95% CI 2.1 to 30). The risk of death was particularly increased from 6 months following exposure (HR 2.16, 95% CI 1.5 to 3.2) and the highest rate of excess mortality was found in children aged 3–4 years. Excess mortality was highest among children with close contact with an adult with sputum-positive pulmonary TB (HR 1.90, 95% CI 1.1 to 3.2), but contact with a sputum-negative case was also associated with increased mortality (HR 1.55, 95% CI 1.0 to 2.3). Adjusting for potential confounding factors did not change these results. The mortality among children living in the same houses 3 years earlier was not increased (HR 0.90, 95% CI 0.6 to 1.3). CONCLUSION: Intimate family contact with a TB case represents a significant risk factor for child mortality in a low-income country.
Authors: Leonardo Martinez; Ye Shen; Andreas Handel; Srijita Chakraburty; Catherine M Stein; LaShaunda L Malone; W Henry Boom; Frederick D Quinn; Moses L Joloba; Christopher C Whalen; Sarah Zalwango Journal: Lancet Respir Med Date: 2017-12-19 Impact factor: 30.700
Authors: Sylvia M LaCourse; Anjuli D Wagner; Lisa M Cranmer; Audrey Copeland; Elizabeth Maleche-Obimbo; Barbra A Richardson; Daniel Matemo; John Kinuthia; Grace John-Stewart Journal: J Acquir Immune Defic Syndr Date: 2019-09-01 Impact factor: 3.731
Authors: Stephen M Graham; Charalambos Sismanidis; Heather J Menzies; Ben J Marais; Anne K Detjen; Robert E Black Journal: Lancet Date: 2014-03-24 Impact factor: 79.321
Authors: Victor Francisco Gomes; Andreas Andersen; Grethe Lemvik; Christian Wejse; Ines Oliveira; Fina J Vieira; Luis José Carlos; Cesaltina da Silva Vieira; Peter Aaby; Per Gustafson Journal: BMJ Open Date: 2013-03-26 Impact factor: 2.692