Tuberculosis infection in Zambia: the association with relative wealth.
This study aimed to assess the association between household socioeconomic position and tuberculosis (TB) infection in two communities of Zambia. For this purpose we implemented a cross-sectional investigation, nested within a larger case control study. Infection was assessed using Quantiferon-TB Gold. A socioeconomic position index was constructed through principal component analysis combining data on human resources, food availability, housing quality, and access to services and infrastructures. In this study, higher socioeconomic position, rather than lower, was associated with significantly higher risk of TB infection. None of the traditional risk factors for TB infection mediated this association, suggesting that in these two communities TB transmission may occur through exposure to as yet undefined risk factors that are associated with higher socioeconomic position. Although further studies are needed, these results suggest emerging new patterns of TB transmission and a role of socioeconomic position on the risk of TB infection opposite to that expected.
Boccia
Delia
D
Department of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom. delia.boccia@lshtm.ac.uk
Hargreaves
James
J
Ayles
Helen
H
Fielding
Katherine
K
Simwinga
Musonda
M
Godfrey-Faussett
Peter
P
D000293:Adolescent; D000328:Adult; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D005260:Female; D005523:Food Supply; D006798:Housing; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012923:Social Class; D012959:Socioeconomic Factors; D014376:Tuberculosis / Q000453:epidemiology*; D014881:Water Supply; D055815:Young Adult; D015024:Zambia / Q000453:epidemiology