Contextual Effect of Village on the Incidence of Tuberculosis in Children in Surakarta, Central Java: A Multilevel Analysis Evidence

Dyah Ayu Saputri, Yulia Lanti Retno Dewi, Bhisma Murti

Abstract

Background: Indonesia is in the second place with the highest burden of tuberculosis (TB) in the world. Childhood is a period of rapid growth that requires efforts to maintain children's health. At the time the child still has a low immune system making it vulnerable to a disease including TB. The problem of TB in children requires better attention in child TB control programs. This study aimed to analyze the contextual influence of villages on the incidence of TB in children.

Subjects and Method: This was a case-control study conducted in 25 villages in Surakarta, Central Java, from August to September 2019. A sample of 200 children aged 0 to 18 years was selected by fixed disease sampling. The dependent variable was the incidence of TB in children. The in­de­pen­dent variables were birth weight, BCG immunization, exclusive breastfeeding, nutritional sta­tus, parental income, home sanitation, exposure to cigarette smoke, family history of TB, and con­­textual effect of village. Data on TB were obtained from medical record in Su­­rakarta community health center. The other data was collected by questionnaire. The data was analyzed by multilevel mul­tiple logistic regression with Stata 13.

Results: The risk of TB in children increased poor house sanitation (OR= 6.70; 95% CI= 1.14 to 39.27; p= 0.035), high exposure to cigarette smoke (OR= 6.71; 95% CI= 1.09 to 41.25; p= 0.040), and family history of TB (OR= 6.01; 95% CI= 1.36 to 26.39; p= 0.018). The risk of TB in children decreased with normal birth weight (≥2500 g) (OR= 0.12; 95% CI= 0.02 to 0.60; p= 0.009), BCG immunization (OR= 0.17; 95% CI= 0.04 to 0.64; p= 0.009 ), exclusive breastfeeding (OR= 0.08; 95% CI= 0.01 to 0.57; p= 0.011), good nutri­tio­nal status (OR= 0.11; 95% CI= 0.02 to 0.66; p= 0.016), and parental income ≥Rp 1,802,700 (OR= 0.07; 95% CI= 0.01 to 0.37; p= 0.002). Village had strong contextual effect on the risk of TB in children with intra-class correlation (ICC)= 29.24%.

Conclusion: The risk of TB in children increases poor house sanitation, high exposure to cigarette smoke, and family history of TB. The risk of TB in children decreases with birth weight ≥2500 g, BCG immunization, exclusive breastfeeding, good nutri­tio­nal status, and high parental income. Village has strong contextual effect on the risk of TB in children.

Keywords: Tuberculosis, risk factors, children aged 0-18 years, multilevel analysis.

Correspondence: Dyah Ayu Saputri. Masters Program in Public Health, Universitas Sebelas Maret, Jl. Ir. Sutami 36 A, Surakarta, Central Java 57126. Email: ayusaputridyah7@gmail.com. Mobile: 081353236388.

Journal of Epidemiology and Public Health (2019), 4(4): 361-372
https://doi.org/10.26911/jepublichealth.2019.04.04.11

 

Full Text:

PDF

References

Adesanya OA, Chiao C (2016). A multilevel analysis of lifestyle variations in symptoms of acute respiratory infection among young children under five in Nigeria. BMC Public Health. 16(1): 880. https://doi.org/10.1186/s128890163565-0


Adetifa IMO, Kendall L, Donkor S, Lugos MD, Hammond AS, Owiafe PK, Hill PC (2017). Mycobacterium tuberculosis infection in close childhood contacts of adults with pulmonary tuberculosis is increased by secondhand exposure to tobacco. Am J Trop Med Hyg. 97(2): 429–432. https://doi.org/10.4269/ajtmh.10611


Alyahya IA, Almohsen HA, Alsaleem IA, Mishari MAA, Turki, Yousef A, Abdulmajeed, Abdulrahman, Aljasser MAA (2017). Assessment of knowledge, attitude, and practice about first aid among male school teachers and administrators in Riyadh, Saudi Arabia. Journal of Family Medicine and Primary Care. 6(2): 169–170. https://doi.org/10.4103/jfmpc.jfmpc


Ari NP, Yulia LRN, Setyo SR (2019). Factors associated with success rate for tuberculosis treatment in hospital: a directly observed treatment short tuberculosis prevention strategy in central java. J Epidemiol Public Health. 4(4): 283-295. https://doi.org/10.26911/jepublichealth.2019.04.04.03.


Aziz KH (2018). Hubungan pemberian ASI eksklusif dengan kejadian tuberkulosis paru pada anak. Jurnal Info Kesehatan. 16(2): 0216-504. https://doi.org/10.31965/infokes


Bai X, Aerts SL, Verma D, Ordway DJ, Chan ED (2018). Epidemiologic evidence of and potential mechanisms by which second-hand smoke causes predisposition to latent and active tuberculosis. Immune Network. 18(3): 1–19. https://doi.org/10.4110/in.2018.18.e22.


Caesar V, Fidelia M, Rachel JEJ (2017). The impact of eimeria tenella co-infection on campylobacter jejuni colonisation of the chicken. Infection and immunity. LSHTM Research Online. 61: 61–67. https://doi.org/10.17037/PUBS.03482693.


Chisti MJ, Ahmed T, Shahid ASMSB, Shahunja KM, Bardhan PK, Faruque ASG, Salam MA (2015). Socio-demographic, epidemiological, and clinical risk factors for childhood pulmonary tuberculosis in severely malnourished children presenting with pneumonia: observation in an urban hospital in Bangladesh. Glob Pediatr Health. 2: 2333794X15594183. doi: 10.1177/2333794X15594183.


Cross GB, Coles K, Nikpour M, Moore OA, Denholm J, McBryde ES (2014). TB incidence and characteristics in the remote gulf province of Papua New Guinea: a prospective study. BMC Infect Dis. 14: 93. doi: 10.1186/1471-2334-14-93.


Duarte R, Lonnroth K, Carvalho C, Lima F, Carvalho ACC, Munoz TM, Centis R (2018). Tuberculosis, social determinants and co-morbidities (including HIV). Pulmonology. 24(2): 115–119. https://doi.org/10.1016/j.rppnen.2017.11.003


Fitriani TG, Rahardjo SS, Prasetya H (2019). Biological and social economic determinants of adherence and cure of tuberculosis treatment: path analysis evidence from Yogyakarta. J Epidemiol Public Health. 4(4): 270-282. https://doi.org/10.26911/jepublichealth.2019.04.04.02


Grant CC, Wall CR, Gibbons MJ, Morton SM, Santosham M, Blach RE (2011). Child nutrition and lower respiratory tract disease burden in New Zealand: a global context for a national perspective. J Paediatr Child Health. 47 (8): 497-504. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/21040074


Hanieh S, Ha TT, Simpson JA, Thuy TT, Khuong NC, Thoang DD, Biggs BA (2015). Exclusive breast feeding in early infancy reduces the risk of inpatient admission for diarrhea and suspected pneumonia in rural Vietnam: A prospective cohort study. BMC Public Health. 15(1): 1-10. doi: 10.1186/s12889-015-2431-9


Hu Y, Zhao Q, Wu L, Wang W, Yuan Z, Xu B (2013). Prevalence of latent tuberculosis infection and its risk factors in schoolchildren and adolescents in Shanghai, China. Eur J Public Health. 23(6): 1064-9. doi: 10.1093/eurpub/ckt105.


Ibrahim MK, Zambruni M, Melby CL, Melby PC (2017). Impact of childhood malnutrition on host defense and infection. Clin Microbiol Rev. 30(4): 919-971. doi: 10.1128/CMR.00119-16.


Jain SK, Ordonez A, Kinikar A, Gupte N, Thakar M, Mave V (2013). Pediatric tuberculosis in young children in India: a prospective study. Biomed Res Int. 20(13): 783698. doi: 10.1155/2013/783698.


Karim M, Rahman MA, Mamun SA, Alam MA, Akhter S (2012). Risk factors of childhood tuberculosis: a case control study from rural Bangladesh. WHO South East Asia. J Public Health. 1(1): 76-84. doi: 10.4103/22243151.206917.


Koretskaya NM, Narkevich AN, Narkevich AA, Grin EN (2017). Tuberculosis and tobacco smoking: a risk of development and specific features in smoking patients. Pulmonologiya. 27(1): 51–55. https://doi.org/10.18093/0869-0189-2017-27-1-51-55


Lee WB, Brown HL, Steele G (2003). Assessing parental birth weight as a risk factor for low-birth-weight delivery. Obstetrics gynecology. 101: 40S. https://doi.org/10.1097/00006-250-200304001-00092


Ministry of Health (2019). Pusat data dan Informasi kementerian kesehatan 2019. Retrieved from https://www.depkes.go.id/resources/download/pusdatin/profil-kesehatanindonesia/Data-dan Informasi_Profil-KesehatanIndonesia2019.pdf


Ministry of Health (2015). Profil Kesehatan RI 2015. Profil Kesehatan Indonesia Tahun 2015. https://doi.org/10.1111/evo.12990


Murakami R, Matsuo N, Ueda K, Nakazawa M (2019). Epidemiological and spatial factors for tuberculosis: A matched case-control study in Nagata, Japan. Int Jurnal Tuberc Lung Dis. 23(2): 181-186. doi: 10.5588/ijtld.18.0369


Patra J, Bhatia M, Suraweera W, Morris SK, Patra C, Gupta PC, Jha P (2015) Exposure to second-hand smoke and the risk of tuberculosis in children and adults: a systematic review and meta-analysis of 18 observational studies. PLoS Med. 12(6): e1001835. doi: 10.1371/journal.pmed.1001835


Ramadhiana Y, Probandari AN, Setianingsih W (2016). Factors associated with success rate for tuberculosis treatment in hospital: A directly observed treatment short tuberculosis prevention strategy in Central Java. J Epidemiol Public Health. 4(4): 283-295. https://doi.org/10.26911/jepublichealth.2019.04.04.03


Setiyaningsih R, Lanti Y, Dewi R, Adriani RB (2019). Contextual effect of school on the risk obesity among high school students in Surakarta, Central Java: A Multilevel Analysis Evidence. J Epidemiol Public Health. 4(4): 328-337. https://doi.org/10.26911/jepublichealth.2019.04.04.08


Shimeles E, Enquselassie F, Aseffa A, Tilahun M, Mekonen A, Wondimagegn G, et al (2019) Risk factors for tuberculosis: a case control study in addis ababa, Ethiopia. PLoS ONE. 14(4): e0214235. https://doi.org/10.1371/journal.pone.0214235


Simkovich SM, Goodman D, Roa C, Crocker ME, Gianella GE, Kirenga BJ (2019). The health and social implications of household air pollution and respiratory diseases. NPJ Prim Care Respir Med. 29(1): 12. doi: 10.1038/s41533-019-0126-x


Tekle AG, Worku A, Birhane Y (2015). Factors associated with acute respiratory infection in children under the age of 5 years: evidence from the 2011 Ethiopia Demographic and Health Survey. P Health Medicine and Therapeutics. 129. https://doi.org/10.2147/phmt.s87065


WHO (2016). Integrated Management of Childhood Illness (IMCI) (Revised). Geneva: WHO/ UNICEF. Retrieved from https://www.who.int/maternal_child_adolescent/topics/child/imci/en/


Xin H, Zhang H, Liu J, Pan S, Li X, Cao X, et al. (2019). Mycobacterium tuberculosis infection among the elderly in 20 486 rural residents aged 50-70 years in Zhongmu County, China. Clin Microbiol Infect. 25(9): 1120-1126. doi: 10.1016/j.cmi.2019.01.021


Refbacks

  • There are currently no refbacks.