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The Association between Household Socioeconomic Position and Prevalent Tuberculosis in Zambia: A Case-Control Study

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  • Delia Boccia
  • James Hargreaves
  • Bianca Lucia De Stavola
  • Katherine Fielding
  • Ab Schaap
  • Peter Godfrey-Faussett
  • Helen Ayles

Abstract

Background: Although historically tuberculosis (TB) has been associated with poverty, few analytical studies from developing countries have tried to: 1. assess the relative impact of poverty on TB after the emergence of HIV; 2. explore the causal mechanism underlying this association; and 3. estimate how many cases of TB could be prevented by improving household socioeconomic position (SEP). Methods and Findings: We undertook a case-control study nested within a population-based TB and HIV prevalence survey conducted in 2005–2006 in two Zambian communities. Cases were defined as persons (15+ years of age) culture positive for M. tuberculosis. Controls were randomly drawn from the TB-free participants enrolled in the prevalence survey. We developed a composite index of household SEP combining variables accounting for four different domains of household SEP. The analysis of the mediation pathway between household SEP and TB was driven by a pre-defined conceptual framework. Adjusted Population Attributable Fractions (aPAF) were estimated. Conclusions: While the fight against HIV remains central for TB control, interventions addressing low household SEP and, especially food availability, may contribute to strengthen our control efforts.

Suggested Citation

  • Delia Boccia & James Hargreaves & Bianca Lucia De Stavola & Katherine Fielding & Ab Schaap & Peter Godfrey-Faussett & Helen Ayles, 2011. "The Association between Household Socioeconomic Position and Prevalent Tuberculosis in Zambia: A Case-Control Study," PLOS ONE, Public Library of Science, vol. 6(6), pages 1-11, June.
    • Handle: RePEc:plo:pone00:0020824
    DOI: 10.1371/journal.pone.0020824
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    References listed on IDEAS

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    1. Ali Taghipour & Mehrdad Mosadegh & Fatemeh Kheirollahzadeh & Meysam Olfatifar & Hossein Safari & Mohammad Javad Nasiri & Atefeh Fathi & Milad Badri & Hadi Piri Dogaheh & Taher Azimi, 2019. "Are intestinal helminths playing a positive role in tuberculosis risk? A systematic review and meta-analysis," PLOS ONE, Public Library of Science, vol. 14(10), pages 1-13, October.
    2. Olivia Oxlade & Megan Murray, 2012. "Tuberculosis and Poverty: Why Are the Poor at Greater Risk in India?," PLOS ONE, Public Library of Science, vol. 7(11), pages 1-8, November.
    3. Syed Mustafa Ali & Naveed Anjum & Muhammad Ishaq & Farah Naureen & Arif Noor & Aamna Rashid & Syed Muslim Abbas & Kerri Viney, 2019. "Community Knowledge about Tuberculosis and Perception about Tuberculosis-Associated Stigma in Pakistan," Societies, MDPI, vol. 9(1), pages 1-12, January.
    4. Stephen J Burke & Elliot Lass & Paul Thistle & Lovemore Katumbe & Arif Jetha & Dan Schwarz & Shelly Bolotin & R D Barker & Andrew Simor & Michael Silverman, 2014. "Increased Incidence of Tuberculosis in Zimbabwe, in Association with Food Insecurity, and Economic Collapse: An Ecological Analysis," PLOS ONE, Public Library of Science, vol. 9(2), pages 1-9, February.
    5. Michael Matsangos & Laoura Ziaka & Artistomenis K. Exadaktylos & Jolanta Klukowska-Rötzler & Mairi Ziaka, 2022. "Health Status of Afghan Refugees in Europe: Policy and Practice Implications for an Optimised Healthcare," IJERPH, MDPI, vol. 19(15), pages 1-13, July.
    6. Anna Odone & Amelia C Crampin & Venance Mwinuka & Simon Malema & J Nimrod Mwaungulu & Lumbani Munthali & Judith R Glynn, 2013. "Association between Socioeconomic Position and Tuberculosis in a Large Population-Based Study in Rural Malawi," PLOS ONE, Public Library of Science, vol. 8(10), pages 1-1, October.

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