Risk factors for intrathoracic tuberculosis in children from economic migrant populations of two Dominican Republic bateyes.
OBJECTIVE
The objective of the current study was to identify risk factors for intrathoracic tuberculosis among children living in migrant populations in the Dominican Republic.


METHODS
Cross-sectional study.


METHODS
Dominican Republic bateyes, economic migrant communities of Haitian origin.


METHODS
Children 18 months to 18 years of age.


METHODS
Unpasteurized milk consumption.


METHODS
Probable or possible intrathoracic tuberculosis. Probable intrathoracic tuberculosis was defined as any child with a tuberculin skin test >or=10 mm (or >5 mm in the presence of a known immunocompromising condition or household contact with intrathoracic tuberculosis) or malnutrition in the setting of an abnormal chest radiograph with features of tuberculosis or lymph node disease. The diagnosis of "possible intrathoracic tuberculosis" was assigned if an abnormal chest radiograph had features that did not meet the definition of "probable intrathoracic tuberculosis."


RESULTS
Probable or possible tuberculosis was diagnosed in 83 (20.8%) of 400 children. Unpasteurized milk consumption was identified as an independent risk factor for intrathoracic tuberculosis (adjusted odds ratio, 3.2; 95% confidence interval: 1.4-7.4) even after adjusting for Bacille Calmette-Guérin vaccination, household size, tuberculosis contacts and age and under varying assumptions about children diagnosed with "possible" tuberculosis.


CONCLUSIONS
Our data raise the possibility that the high prevalence of tuberculosis in the Dominican Republic bateyes may be attributable to Mycobacterium bovis rather than Mycobacterium tuberculosis infection.
Cohn
Keri A
KA
Alliance for International Medicine, The Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA.
Finalle
Rodney
R
O'Hare
Geraldine
G
Feris
Jesús M
JM
Fernández
Josefina
J
Shah
Samir S
SS
D000293:Adolescent; D000818:Animals; D002417:Cattle; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D004293:Dominican Republic / Q000453:epidemiology; D054242:Emigrants and Immigrants; D005247:Feeding Behavior; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008892:Milk; D009169:Mycobacterium tuberculosis / Q000302:isolation & purification*; D013902:Radiography, Thoracic; D012307:Risk Factors; D014374:Tuberculin Test; D014380:Tuberculosis, Bovine / Q000453:epidemiology* / Q000382:microbiology; D014397:Tuberculosis, Pulmonary / Q000453:epidemiology* / Q000382:microbiology