title: Epidemiology of tuberculosis in an urban slum of Dhaka City, Bangladesh.
abstract: BACKGROUND
  The objectives of this study were to assess the tuberculosis (TB) burden and to provide an insight into the type of circulating M. tuberculosis species in urban slums of Bangladesh. We also aimed to test the feasibility of a larger transmission study in this setting.
  
  
  METHODS
  This cross-sectional study was conducted in an urban slum of Dhaka city. The household members were actively screened to assess the presence of TB-related signs and symptoms; cough ≥ 3 weeks and body mass index (BMI) <17 kg/m(2). Sputum specimens from suspects were collected for acid fast bacilli (AFB) microscopy, culture and drug susceptibility testing. Genotyping of M. tuberculosis was done using spoligotyping and variable number tandem repeats of mycobacterial interspersed repetitive units typing.
  
  
  RESULTS
  Among 9,877 adult screened for pulmonary TB (PTB), 25 were positive for AFB on microscopy and/or culture and the prevalence of new PTB cases was estimated to be 253/100,000. Only one child TB case was diagnosed among 5,147 child screened. Out of 26 cases, 21(81%) had cough for several duration and 5(19%) did not present with cough at the time of screening. One multidrug resistant case was found. Fifty two percent of all TB cases had BMI <17 kg/m2 (p = <0.001). Among the 20 analyzed isolates, 13 different spoligotype patterns were identified in which 5 clusters contained 12 strains and 8 strains had unique pattern.
  
  
  CONCLUSIONS
  The study revealed high prevalence of TB in urban slums. Screening using low BMI can be beneficial among risk group population. It is important to conduct larger study to validate clinical variables like cough <3 weeks and low BMI to define TB suspect and also to investigate the transmission of TB in slum settings.
authors.affiliation: Centre for Communicable Diseases, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh.
authors.forename: Sayera
authors.initials: S
authors.lastname: Banu
authors.forename: Md Toufiq
authors.initials: MT
authors.lastname: Rahman
authors.forename: Mohammad Khaja Mafij
authors.initials: MK
authors.lastname: Uddin
authors.forename: Razia
authors.initials: R
authors.lastname: Khatun
authors.forename: Tahmeed
authors.initials: T
authors.lastname: Ahmed
authors.forename: Md Mojibur
authors.initials: MM
authors.lastname: Rahman
authors.forename: Md Ashaque
authors.initials: MA
authors.lastname: Husain
authors.forename: Frank
authors.initials: F
authors.lastname: van Leth
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001459:Bangladesh / Q000453:epidemiology; D015992:Body Mass Index; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D005838:Genotype; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D009169:Mycobacterium tuberculosis / Q000235:genetics; D011204:Poverty Areas; D015995:Prevalence; D012424:Rural Population; D014376:Tuberculosis / Q000453:epidemiology* / Q000235:genetics; D055815:Young Adult