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" The Impact of the Residency Area on Risk Factors for Tuberculosis among People Living in Three Different Regions of Kazakhstan "
Bukharbayeva, Assel
Rosenberg, Eli
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Latin Dissertation
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| Language of Document
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English
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| Record Number
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1053690
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| Doc. No
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TL52807
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| Main Entry
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Bukharbayeva, Assel
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| Title & Author
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The Impact of the Residency Area on Risk Factors for Tuberculosis among People Living in Three Different Regions of Kazakhstan\ Bukharbayeva, AsselRosenberg, Eli
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| College
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State University of New York at Albany
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| Date
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2020
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| Degree
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M.S.
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2020
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| Note
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38 p.
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| Abstract
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Background and introduction: Prior studies have shown that several risk factors, including lifetime status of tobacco smoking, alcohol consumption, diabetes, and human immunodeficiency virus diagnosis, lead to increased rates of pulmonary tuberculosis among Kazakhstani population. Our study aimed to estimate the potential modifiable effect of living area on risk factors of pulmonary tuberculosis and estimate the proportion of a disease related to a given exposure in Kazakhstan. Methods: We used secondary data in this matched case-control study. Individuals with pulmonary tuberculosis identified by the national tuberculosis program, and 1038 controls, including age-matched one household and one community controls for each case, were recruited. Conditional logistic regression with backward selection was used to examine the association of sex, marital status, history of incarceration, lifetime status of tobacco smoking and alcohol consumption, and diagnosed with diabetes, with pulmonary tuberculosis. A likelihood ratio test (LRT) was used to estimate an effect modification of risk factors by region of residency. The burden of disease attributable to risk factors was estimated by using the adjusted odds ratio for population-attributable risk (PAR) calculation. Results: In our study, 562 cases of pulmonary tuberculosis and 1038 controls, including 515 household and 523 community controls, were analyzed. The unadjusted odds of developing tuberculosis for individuals with diabetes was 7.95-fold that of individuals without diabetes (95% CI = 3.84–16.47), for persons who ever drank alcohol was 1.77-times that of persons who never drank alcohol (95% CI = 1.38–2.26), for individuals who ever smoke tobacco was 1.80-times that of individuals who never smoke tobacco (95% CI = 1.44–2.25), for persons who had a history of incarceration was 2.51-fold that of persons had no history of incarceration (95% CI = 1.22–5.15) when compared cases to combined controls. According to conditional logistic regression analysis with backward selection method, in the model comparing cases with combined controls, the adjusted odds of developing pulmonary tuberculosis for individuals with diabetes was 8.59-fold that of individuals without diabetes (95% CI = 4.06–18.17) when controlling for other factors in the model. For individuals who ever smoke tobacco, the adjusted odds of pulmonary tuberculosis was 1.50-times that of individuals who never smoke tobacco (95% CI = 1.14–1.97) when adjusted for other factors in the model. The adjusted odds of TB for persons who had a history of incarceration was 2.24-fold that of persons had no history of incarceration (95% CI = 1.03–4.86), holding other factors constant. According to the likelihood ratio test, the association between lifetime status of alcohol consumption and pulmonary tuberculosis significantly different across regions of residency (p-value < 0.05) when compared cases to combined and community controls. Whereas in the Almaty region, the odds of developing tuberculosis for persons who ever drank alcohol was 1.05 - fold that of persons who never drank alcohol (95% CI = 0.71–1.57), this increased to 3.43 in the Kyzylorda region in the first model (95% CI = 1.94–6.06). Also, more than 20% of pulmonary tuberculosis could be attributed to the history of alcohol consumption, according to population attributed risk calculations, when compared cases to combined controls and community controls. Conclusions: The results of our study suggest that the planning of pulmonary tuberculosis preventive interventions for adults should be based not only on the incidence of diagnosed tuberculosis but also on the area characteristics associated with the risk of tuberculosis as well as the proportion of a disease in a population related to a given exposure.
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Asian studies
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Epidemiology
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Rosenberg, Eli
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State University of New York at Albany
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