Characterization of geographic mobility among participants in facility- and community-based tuberculosis case finding in urban Uganda

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dc.contributor.authorRobsky, Katherine O.
dc.contributor.authorIsooba, David
dc.contributor.authorNakasolya, Olga
dc.contributor.authorMukiibi, James
dc.contributor.authorNalutaaya, Annet
dc.contributor.authorKitonsa, Peter J.
dc.contributor.authorKamoga, Caleb
dc.contributor.authorBaik, Yeonsoo
dc.contributor.authorKendall, Emily A.
dc.contributor.authorKatamba, Achilles
dc.contributor.authorDowdy, David W.
dc.date.accessioned2023-01-13T19:33:31Z
dc.date.available2023-01-13T19:33:31Z
dc.date.issued2021
dc.description.abstractInternational and internal migration are recognized risk factors for tuberculosis (TB). Geographic mobility, including travel for work, education, or personal reasons, may also play a role in TB transmission, but this relationship is poorly defined. We aimed to define geographic mobility among participants in facility- and community-based TB case finding in Kampala, Uganda, and to assess associations between mobility, access to care, and TB disease. Methods We included consecutive individuals age �15 years diagnosed with TB disease through either routine health facility practices or community-based case finding (consisting of doorto- door testing, venue-based screening, and contact investigation). Each case was matched with one (for community-based enrollment) or two (health facility enrollment) TB-negative controls. We conducted a latent class analysis (LCA) of eight self-reported characteristics to identify and define mobility; we selected the best-fit model using Bayesian Information Criterion. We assessed associations between mobility and TB case status using multivariable conditional logistic regression. Results We enrolled 267 cases and 432 controls. Cases were more likely than controls to have been born in Kampala (p<0.001); there was no difference between cases and controls for remaining mobility characteristics. We selected a two-class LCA model; the “mobile” class was perfectly correlated with a single variable: travel (>3 km) from residence 2 times per month. Mobility was associated with a 28% reduction in odds of being a TB case (adjusted matched odds ratio 0.72 [95% confidence interval 0.49, 1.06]). Conclusion Frequency of out-of-neighborhood travel is an easily measured variable that correlates closely with predicted mobility class membership. Mobility was associated with decreased risk of TB disease; this may be in part due to the higher socioeconomic status of mobile individuals in this population. However, more research is needed to improve assessment of mobility and understand how mobility affects disease risk and transmission.en_US
dc.identifier.citationRobsky KO, Isooba D, Nakasolya O, Mukiibi J, Nalutaaya A, Kitonsa PJ, et al. (2021) Characterization of geographic mobility among participants in facility- and community-based tuberculosis case finding in urban Uganda. PLoS ONE 16(5): e0251806. https://doi.org/10.1371/ journal.pone.0251806en_US
dc.identifier.urihttps://doi.org/10.1371/ journal.pone.0251806
dc.identifier.urihttps://nru.uncst.go.ug/handle/123456789/6918
dc.language.isoenen_US
dc.publisherPLoS ONEen_US
dc.subjectGeographic mobilityen_US
dc.subjectParticipantsen_US
dc.subjectTuberculosisen_US
dc.titleCharacterization of geographic mobility among participants in facility- and community-based tuberculosis case finding in urban Ugandaen_US
dc.typeArticleen_US
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