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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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    4. 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.
    5. 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.
    6. 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.

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