Resistance and Susceptibility to Mycobacterium tuberculosis Infection and Disease in Tuberculosis Households in Kampala, Uganda

Catherine M. Stein, Sarah Zalwango, Lashaunda L. Malone, Bonnie Thiel, Ezekiel Mupere, Mary Nsereko, Brenda Okware, Hussein Kisingo, Christina Lancioni, Charles M. Bark, Christopher C. Whalen, Moses L. Joloba, W. Henry Boom, Harriet Mayanja-Kizza

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

Tuberculosis (TB), caused by Mycobacterium tuberculosis (Mtb), remains a major public health problem. Household contact studies identify children and adults along the spectrum from Mtb exposure to disease. In the Kawempe Community Health Study (conducted in Kampala, Uganda), 872 culture-confirmed pulmonary TB cases and their 2,585 contacts were enrolled during 2002-2012 and followed for up to 2 years each. Risk factors identified by time-to-event analysis for secondary TB differed among children, women, and men. Younger age (P = 0.0061), human immunodeficiency virus (HIV) (P = 0.0002), thinness (P = 0.01), absent bacille Calmette-Guérin vaccination (P = 0.002), and epidemiologic risk score (P < 0.0001) were risks for children. For women, risks were HIV (P < 0.0001), thinness (World Health Organization criteria; P < 0.0001), and epidemiologic risk score (P = 0.003). For men, HIV (P = 0.0007) and low body mass index (P = 0.008) resulted in faster progression to TB. Tuberculin skin testing (TST) identified contacts with Mtb infection and those with persistently negative TST. Risks for faster time to Mtb infection were identified, and included age (P = 0.0007), baseline TST induration (P < 0.0001), and epidemiologic risk score (P < 0.0001) only in children. Those with persistently negative TST comprised 10% of contacts but had no unique epidemiologic characteristics among adults. The burden of Mtb infection and disease is high in TB households, and risk factors for progression from exposure to infection and disease differ among children, women, and men.

Original languageEnglish (US)
Pages (from-to)1477-1489
Number of pages13
JournalAmerican Journal of Epidemiology
Volume187
Issue number7
DOIs
StatePublished - Jul 1 2018

Fingerprint

Uganda
Mycobacterium tuberculosis
Tuberculosis
Tuberculin
Mycobacterium Infections
Skin
Thinness
HIV
Pulmonary Tuberculosis
Susceptibility to infection by Mycobacterium tuberculosis
Vaccination
Body Mass Index
Public Health
Health
Infection

Keywords

  • case finding
  • case-contact study
  • infectious disease epidemiology
  • Mtb infection
  • pediatric TB
  • resistance to infection

ASJC Scopus subject areas

  • Epidemiology

Cite this

Stein, C. M., Zalwango, S., Malone, L. L., Thiel, B., Mupere, E., Nsereko, M., ... Mayanja-Kizza, H. (2018). Resistance and Susceptibility to Mycobacterium tuberculosis Infection and Disease in Tuberculosis Households in Kampala, Uganda. American Journal of Epidemiology, 187(7), 1477-1489. https://doi.org/10.1093/aje/kwx380

Resistance and Susceptibility to Mycobacterium tuberculosis Infection and Disease in Tuberculosis Households in Kampala, Uganda. / Stein, Catherine M.; Zalwango, Sarah; Malone, Lashaunda L.; Thiel, Bonnie; Mupere, Ezekiel; Nsereko, Mary; Okware, Brenda; Kisingo, Hussein; Lancioni, Christina; Bark, Charles M.; Whalen, Christopher C.; Joloba, Moses L.; Boom, W. Henry; Mayanja-Kizza, Harriet.

In: American Journal of Epidemiology, Vol. 187, No. 7, 01.07.2018, p. 1477-1489.

Research output: Contribution to journalArticle

Stein, CM, Zalwango, S, Malone, LL, Thiel, B, Mupere, E, Nsereko, M, Okware, B, Kisingo, H, Lancioni, C, Bark, CM, Whalen, CC, Joloba, ML, Boom, WH & Mayanja-Kizza, H 2018, 'Resistance and Susceptibility to Mycobacterium tuberculosis Infection and Disease in Tuberculosis Households in Kampala, Uganda', American Journal of Epidemiology, vol. 187, no. 7, pp. 1477-1489. https://doi.org/10.1093/aje/kwx380
Stein, Catherine M. ; Zalwango, Sarah ; Malone, Lashaunda L. ; Thiel, Bonnie ; Mupere, Ezekiel ; Nsereko, Mary ; Okware, Brenda ; Kisingo, Hussein ; Lancioni, Christina ; Bark, Charles M. ; Whalen, Christopher C. ; Joloba, Moses L. ; Boom, W. Henry ; Mayanja-Kizza, Harriet. / Resistance and Susceptibility to Mycobacterium tuberculosis Infection and Disease in Tuberculosis Households in Kampala, Uganda. In: American Journal of Epidemiology. 2018 ; Vol. 187, No. 7. pp. 1477-1489.
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