A matched case-control study to identify risk determinants of tuberculosis in Bangladesh

Abstract

Tuberculosis (TB) remains a major public health problem in Bangladesh. The present study focused on identifying TB risk determinants in Bangladesh. An age-sex matched casecontrol study was conducted with each stratum consisting of one case and two controls. This study covered six divisions of Bangladesh including both the rural and urban areas. TB cases were randomly selected from BRAC TB Control Programme. For each case, two age-sex matched controls were chosen from the community where the case belonged, and in total 360 cases and 720 controls were selected for the study. Information was collected from the selected case and controls via face-to-face interviews. We divided potential risk factors into three categories, which were demographic, socio-economic, and personal health or lifestyle. A conditional logistic regression model was used to determine important risk factors for TB. The adjusted odds ratio (aOR) of primary education was 0.8 (95% CI: 0.52-1.2), secondary and higher level of education was 0.5 (0.32-0.78), compared to zero level of education. The aOR of living in a building was 2.54 (1.44-4.52) compared to living in an improper house/semi-building. The aOR of having previous TB history was 2.04 (1.05-3.94) compared to no history of TB. The aOR of past smokers was 5.27 (2.82-9.86) compared to nonsmokers. In this study, low level of education, type of household, low socio-economic status, previous TB history, and smoking habits were identified as risk factors for TB in Bangladesh. The findings can be used to strengthen the National TB Control Programme by developing social protection interventions and raising awareness about health hazard caused by smoking cigarettes or using tobacco.