title: Risk factors for tuberculosis in older children and adolescents: a matched case-control study in Recife, Brazil.
abstract: BACKGROUND
  Tuberculosis is a major disease worldwide and most research focus on risk factors for adults, although there is a marked adolescent peak in incidence. The objective of this study was to identify risk factors for tuberculosis in children aged 7 to 19.
  
  
  METHODS
  A case control study matched by age with 169 cases and 477 controls. The study population consisted of adolescents and older children from Recife, Brazil. Cases were individuals diagnosed with tuberculosis in the control programme and controls were selected in the neighborhood of cases. Conditional logistic regression was used to identify risk factors.
  
  
  RESULTS
  Cigarette smoking increased by 50% the risk of tuberculosis but that this was not statistically significant (OR = 1.6). Other risk factors were sleeping in the same house as a case of tuberculosis (OR = 31.6), living in a house with no piped water (OR = 7.7) (probably as a proxy for bad living conditions), illiteracy (OR = 3.7) and male sex (OR = 1.8). The increase in risk with living in houses with no piped water was much more marked in males. The proportion of cases of tuberculosis attributed to contact with someone with TB was 38% and to illiteracy, lack of piped water and smoking, 20%.
  
  
  CONCLUSIONS
  Household contact with tuberculosis, social factors and male sex play the biggest role in determining risk of TB disease among children and adolescents in the study. We recommend further research on the relationship of cigarette smoking on tuberculosis in adolescents, and on whether the sex differentials are more marked in bad living conditions. Separate studies should be conducted in older children and in adolescents.
authors: Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT UK.
authors: Hilary
authors: H
authors: Stevens
authors: Department Medicina Tropical, Universidade Federal do Pernambuco, Bl. A do Hospital das Clinicas. Av. Prof. Moraes Rego s/n, Cidade Universitária, Recife, PE 50670-420 Brazil ; Department Medicina Interna, Universidade de Pernambuco, Recife, Brazil.
authors: Ricardo Aa
authors: RA
authors: Ximenes
authors: Department Medicina Tropical, Universidade Federal do Pernambuco, Bl. A do Hospital das Clinicas. Av. Prof. Moraes Rego s/n, Cidade Universitária, Recife, PE 50670-420 Brazil ; Department de Saúde Materno Infantil, Universidade Federal do Pernambuco, Recife, Brazil.
authors: Odimariles Ms
authors: OM
authors: Dantas
authors: Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT UK.
authors: Laura C
authors: LC
authors: Rodrigues
keywords: Adolescents; Household contacts; Risk factors; Smoking; Socio-economic factors; Tuberculosis
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