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Prevalence and Determinants of QuantiFERON-Diagnosed Tuberculosis Infection in 9810 Mongolian Schoolchildren
Зохиогч
Davaasambuu Ganmaa
Polyna Khudyakov
Uyanga Buyanjargal
Badamtsetseg Jargalsaikhan
Delgerekh Baigal
Oyunsuren Munkhjargal
Narankhuu Yansan
Sunjidmaa Bolormaa
Christopher T. Sempos
Sabri Bromage
Zhenqiang Wu
Batbayar Ochirbat
Batbaatar Gunchin
Adrian R. Martineau
Он
2018 оны арван нэгдүгээр сарын 26
Төрөл
journal article
Хэвлэгч
Oxford University Press
Journal
Clinical Infectious Diseases
Volume
69
Issue
5
Start Page
813
End Page
819
ISSN
1058-4838
1537-6591
Хураангуй
BACKGROUND: There is controversy regarding the potential influence of vitamin D deficiency, exposure to environmental tobacco smoke, BCG vaccination, season, and body habitus on susceptibility to Mycobacterium tuberculosis (MTB) infection. METHODS: We conducted a cross-sectional analysis to identify determinants of a positive QuantiFERON-TB Gold (QFT) assay result in children aged 6-13 years attending 18 schools in Ulaanbaatar, Mongolia. Data relating to potential risk factors for MTB infection were collected by questionnaire, physical examination, and determination of serum 25-hydroxyvitamin D (25[OH]D) concentrations. Risk ratios (RRs) were calculated with adjustment for potential confounders, and population attributable fractions (PAFs) were calculated for modifiable risk factors identified. RESULTS: Nine hundred forty-six of 9810 (9.6%) participants had a positive QFT result. QFT positivity was independently associated with household exposure to pulmonary tuberculosis (adjusted RR [aRR], 4.75 [95% confidence interval {CI}, 4.13-5.46, P < .001]; PAF, 13.1% [95% CI, 11.1%-15.0%]), vitamin D deficiency (aRR, 1.23 [95% CI, 1.08-1.40], P = .002; PAF, 5.7% [95% CI, 1.9%-9.3%]), exposure to environmental tobacco smoke (1 indoor smoker, aRR, 1.19 [95% CI, 1.04-1.35]; ≥2 indoor smokers, aRR, 1.30 [95% CI, 1.02-1.64]; P for trend = .006; PAF, 7.2% [95% CI, 2.2%-12.0%]), and increasing age (aRR per additional year, 1.14 [95% CI, 1.10-1.19], P < .001). No statistically significant independent association was seen for presence of a BCG scar, season of sampling, or body mass index. CONCLUSIONS: Vitamin D deficiency and exposure to environmental tobacco smoke are potentially modifiable risk factors for MTB infection.