title: Risk factors for pulmonary tuberculosis in Croatia: a matched case-control study.
abstract: BACKGROUND
  Mycobacterium tuberculosis is a necessary, but not sufficient, cause of tuberculosis. A number of studies have addressed the issue of risk factors for tuberculosis development. Croatia is a European country with an incidence rate of 14/100 000 which is slowly decreasing. The aim of this study is to evaluate the potential demographic, socioeconomic, behavioural and biological risk factors for tuberculosis in Croatia in comparison to other high-income, low-incidence European countries.
  
  
  METHODS
  A total of 300 tuberculosis patients were matched for age, sex and county of residence to 300 controls randomly selected from general practitioners' registers. They were interviewed and their medical records were evaluated for variables broadly described as potential risk factors.
  
  
  RESULTS
  In multiple logistic regression, the following factors were significant: parents born in a particular neighbouring county (Bosnia and Herzegovina) (OR = 3.90, 95% CI 2.01-7.58), the lowest level of education (OR = 3.44, 95% CI 1.39-8.50), poor household equipment (OR = 4.72, 95% CI 1.51-14.76), unemployment (OR = 2.69, 95% CI 1.18-6.16), contact with tuberculosis (OR = 2.19, 95% CI 1.27-3.77), former (OR = 2.27, 95% CI 1.19-4.33) and current smoking habits (OR = 2.35, 95% CI 1.27-4.36), diabetes (OR = 2.38, 95% CI 1.05-5.38), a malignant disease (OR = 5.79, 95% CI 1.49-22.42), being underweight in the previous year (OR = 13.57, 95% CI 1.21-152.38).
  
  
  CONCLUSIONS
  In our study, the identified risk groups for tuberculosis reflect a complex interaction between socioeconomic conditions, lifestyle and non-communicable diseases. Interventions focused on poverty will undoubtedly be useful, but not sufficient. Tuberculosis control would benefit from a combination of broad public health activities aimed at the prevention and control of risky lifestyles and non-communicable diseases, interventions outside the health sector, and efforts to constantly improve the Croatian national tuberculosis programme.
authors.affiliation: Teaching Public Health Institute of Split and Dalmatia County, Vukovarska 46, 21 000 Split, Croatia. anamarijajs@gmail.com.
authors.forename: Anamarija
authors.initials: A
authors.lastname: Jurcev-Savicevic
authors.forename: Rosanda
authors.initials: R
authors.lastname: Mulic
authors.forename: Bozica
authors.initials: B
authors.lastname: Ban
authors.forename: Karlo
authors.initials: K
authors.lastname: Kozul
authors.forename: Ljiljana
authors.initials: L
authors.lastname: Bacun-Ivcek
authors.forename: Jasna
authors.initials: J
authors.lastname: Valic
authors.forename: Gordana
authors.initials: G
authors.lastname: Popijac-Cesar
authors.forename: Snjezana
authors.initials: S
authors.lastname: Marinovic-Dunatov
authors.forename: Majda
authors.initials: M
authors.lastname: Gotovac
authors.forename: Aleksandar
authors.initials: A
authors.lastname: Simunovic
mesh_terms: D000293:Adolescent; D000328:Adult; D017522:Bosnia and Herzegovina / Q000453:epidemiology; D016022:Case-Control Studies; D015897:Comorbidity; D017523:Croatia / Q000453:epidemiology; D003920:Diabetes Mellitus / Q000453:epidemiology; D005260:Female; D015438:Health Behavior; D006304:Health Status; D006801:Humans; D015994:Incidence; D008019:Life Style; D016015:Logistic Models; D008297:Male; D010290:Parents; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology; D012959:Socioeconomic Factors; D014397:Tuberculosis, Pulmonary / Q000453:epidemiology*; D055815:Young Adult