Social determinants of tuberculosis evaluation among household contacts: a secondary analysis
Seven public sector tuberculosis (TB) units and surrounding communities in Kampala, Uganda. To evaluate the influence of household-level socio-economic characteristics on completion of TB evaluation during household contact investigation. A cross-sectional study nested within the control arm of a ra...
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Published in | Public health action Vol. 8; no. 3; pp. 118 - 123 |
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Main Authors | , , , , , , , |
Format | Journal Article |
Language | English |
Published |
France
International Union Against Tuberculosis and Lung Disease
21.09.2018
The Union |
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Abstract | Seven public sector tuberculosis (TB) units and surrounding communities in Kampala, Uganda.
To evaluate the influence of household-level socio-economic characteristics on completion of TB evaluation during household contact investigation.
A cross-sectional study nested within the control arm of a randomized, controlled trial evaluating home-based sputum collection and short messaging service communications. We used generalized estimating equations to estimate the association between completion of TB evaluation and socio-economic determinants.
Of 116 household contacts referred to clinics for TB evaluation, 32 (28%) completed evaluation. Completing evaluation was strongly clustered by household. Controlling for individual symptoms, contacts from households earning below-median income (adjusted risk ratio [aRR] 0.28, 95%CI 0.09-0.88,
0.029) and contacts from households in which the head of household had no more than primary-level education (aRR 0.40, 95%CI 0.18-0.89,
0.025) were significantly less likely to complete evaluation for TB.
Socio-economic factors such as low income and education increase the risk that household contacts of TB patients will experience barriers to completing TB evaluation themselves. Further research is needed to identify specific mechanisms by which these underlying social determinants modify the capability and motivation of contacts to complete contact investigation. |
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AbstractList | Seven public sector tuberculosis (TB) units and surrounding communities in Kampala, Uganda.
To evaluate the influence of household-level socio-economic characteristics on completion of TB evaluation during household contact investigation.
A cross-sectional study nested within the control arm of a randomized, controlled trial evaluating home-based sputum collection and short messaging service communications. We used generalized estimating equations to estimate the association between completion of TB evaluation and socio-economic determinants.
Of 116 household contacts referred to clinics for TB evaluation, 32 (28%) completed evaluation. Completing evaluation was strongly clustered by household. Controlling for individual symptoms, contacts from households earning below-median income (adjusted risk ratio [aRR] 0.28, 95%CI 0.09-0.88,
0.029) and contacts from households in which the head of household had no more than primary-level education (aRR 0.40, 95%CI 0.18-0.89,
0.025) were significantly less likely to complete evaluation for TB.
Socio-economic factors such as low income and education increase the risk that household contacts of TB patients will experience barriers to completing TB evaluation themselves. Further research is needed to identify specific mechanisms by which these underlying social determinants modify the capability and motivation of contacts to complete contact investigation. Setting: Seven public sector tuberculosis (TB) units and surrounding communities in Kampala, Uganda. Objective: To evaluate the influence of household-level socio-economic characteristics on completion of TB evaluation during household contact investigation. Design: A cross-sectional study nested within the control arm of a randomized, controlled trial evaluating home-based sputum collection and short messaging service communications. We used generalized estimating equations to estimate the association between completion of TB evaluation and socio-economic determinants. Results: Of 116 household contacts referred to clinics for TB evaluation, 32 (28%) completed evaluation. Completing evaluation was strongly clustered by household. Controlling for individual symptoms, contacts from households earning below-median income (adjusted risk ratio [aRR] 0.28, 95%CI 0.09–0.88, P = 0.029) and contacts from households in which the head of household had no more than primary-level education (aRR 0.40, 95%CI 0.18–0.89, P = 0.025) were significantly less likely to complete evaluation for TB. Conclusion: Socio-economic factors such as low income and education increase the risk that household contacts of TB patients will experience barriers to completing TB evaluation themselves. Further research is needed to identify specific mechanisms by which these underlying social determinants modify the capability and motivation of contacts to complete contact investigation. Setting: Seven public sector tuberculosis (TB) units and surrounding communities in Kampala, Uganda. Objective: To evaluate the influence of household-level socio-economic characteristics on completion of TB evaluation during household contact investigation. Design: A cross-sectional study nested within the control arm of a randomized, controlled trial evaluating home-based sputum collection and short messaging service communications. We used generalized estimating equations to estimate the association between completion of TB evaluation and socio-economic determinants. Results: Of 116 household contacts referred to clinics for TB evaluation, 32 (28%) completed evaluation. Completing evaluation was strongly clustered by household. Controlling for individual symptoms, contacts from households earning below-median income (adjusted risk ratio [aRR] 0.28, 95%CI 0.09-0.88, P = 0.029) and contacts from households in which the head of household had no more than primary-level education (aRR 0.40, 95%CI 0.18-0.89, P = 0.025) were significantly less likely to complete evaluation for TB. Conclusion: Socio-economic factors such as low income and education increase the risk that household contacts of TB patients will experience barriers to completing TB evaluation themselves. Further research is needed to identify specific mechanisms by which these underlying social determinants modify the capability and motivation of contacts to complete contact investigation. |
Author | Turimumahoro, P. Ochom, E. Davis, J. L. Meyer, A. J. Babirye, D. Armstrong-Hough, M. Shelby, T. Katamba, A. |
Author_xml | – sequence: 1 givenname: T. surname: Shelby fullname: Shelby, T. organization: Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, Connecticut, USA, Yale School of Medicine, New Haven, Connecticut, USA – sequence: 2 givenname: A. J. surname: Meyer fullname: Meyer, A. J. organization: Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, Connecticut, USA, Uganda Tuberculosis Implementation Research Consortium, Makerere University, Kampala, Uganda – sequence: 3 givenname: E. surname: Ochom fullname: Ochom, E. organization: Uganda Tuberculosis Implementation Research Consortium, Makerere University, Kampala, Uganda – sequence: 4 givenname: P. surname: Turimumahoro fullname: Turimumahoro, P. organization: Uganda Tuberculosis Implementation Research Consortium, Makerere University, Kampala, Uganda – sequence: 5 givenname: D. surname: Babirye fullname: Babirye, D. organization: Uganda Tuberculosis Implementation Research Consortium, Makerere University, Kampala, Uganda – sequence: 6 givenname: A. surname: Katamba fullname: Katamba, A. organization: Uganda Tuberculosis Implementation Research Consortium, Makerere University, Kampala, Uganda, Clinical Epidemiology Unit, Makerere University, Kampala, Uganda – sequence: 7 givenname: J. L. surname: Davis fullname: Davis, J. L. organization: Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, Connecticut, USA, Uganda Tuberculosis Implementation Research Consortium, Makerere University, Kampala, Uganda, Pulmonary, Critical Care, and Sleep Medicine Section, Yale School of Medicine, New Haven, Connecticut, USA – sequence: 8 givenname: M. surname: Armstrong-Hough fullname: Armstrong-Hough, M. organization: Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, Connecticut, USA, Uganda Tuberculosis Implementation Research Consortium, Makerere University, Kampala, Uganda |
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Snippet | Seven public sector tuberculosis (TB) units and surrounding communities in Kampala, Uganda.
To evaluate the influence of household-level socio-economic... Setting: Seven public sector tuberculosis (TB) units and surrounding communities in Kampala, Uganda. Objective: To evaluate the influence of household-level... Setting: Seven public sector tuberculosis (TB) units and surrounding communities in Kampala, Uganda. Objective: To evaluate the influence of household-level... |
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SubjectTerms | Active Case Finding Contact Investigation Original Uganda |
Title | Social determinants of tuberculosis evaluation among household contacts: a secondary analysis |
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