Burden of tuberculosis disease among adolescents in a rural cohort in Eastern Uganda
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Date
2013
Journal Title
Journal ISSN
Volume Title
Publisher
BMC Infectious Diseases,
Abstract
Background: The world health organization (WHO) declared tuberculosis (TB) a global emergency, mainly affecting
people in sub-Saharan Africa. However there is little data about the burden of TB among adolescents. We estimated the
prevalence and incidence of TB and assessed factors associated with TB among adolescents aged 12–18 years in a rural
population in Uganda in order to prepare the site for phase III clinical trials with novel TB vaccines among adolescents.
Methods: In a prospective cohort study, we recruited 5000 adolescents and followed them actively, every 6 months,
for 1–2 years. Participants suspected of having TB were those who had any of; TB signs and symptoms, history of TB
contact or a positive tuberculin skin test (TST) of ≥10 mm. Laboratory investigations included sputum smear
microscopy and culture.
Results: Of the 5000 participants, eight culture confirmed cases of TB were found at baseline: a prevalence of
160/100,000 (95% confidence interval (CI), 69–315). There were 13 incident TB cases detected in an average of 1.1
person years: an incidence of 235/100,000 person years (95% CI, 125–402). None of the confirmed TB cases were HIV
infected. Predictors for prevalent TB disease were: a history of TB contact and a cough ≥ 2 weeks at baseline and being
out of school, while the only predictor for incident TB was a positive TST during follow-up.
Conclusion: The TB incidence among adolescents in this rural part of Uganda seemed too low for a phase III TB
vaccine trial. However, the study site demonstrated capability to handle a large number of participants with minimal
loss to follow-up and its suitability for future clinical trials. Improved contact tracing in TB program activities is likely to
increase TB case detection among adolescents. Future studies should explore possible pockets of higher TB incidence
in urban areas and among out of school youth
Description
Keywords
Tuberculosis, Adolescents, Rural cohort, Eastern Uganda
Citation
Waako, J., Verver, S., Wajja, A., Ssengooba, W., Joloba, M. L., Colebunders, R., ... & Mayanja-Kizza, H. (2013). Burden of tuberculosis disease among adolescents in a rural cohort in Eastern Uganda. BMC Infectious Diseases, 13(1), 1-8.doi:10.1186/1471-2334-13-349