Hierarchical true prevalence, risk factors and clinical symptoms of tuberculosis among suspects in Bangladesh

Mohammad Kamruzzaman Khan; Md Nazimul Islam; Jayedul Hassan; Shaymal Kumar Paul; M Ariful Islam; Konstantinos Pateras; Polychronis Kostoulas; Michael P Ward; A K M Anisur Rahman; Md Mahbub Alam

doi:10.1371/journal.pone.0262978

Hierarchical true prevalence, risk factors and clinical symptoms of tuberculosis among suspects in Bangladesh

PLoS One. 2022 Jul 12;17(7):e0262978. doi: 10.1371/journal.pone.0262978. eCollection 2022.

Affiliations

¹ Faculty of Veterinary Science, Department of Medicine, Bangladesh Agricultural University, Mymensingh, Bangladesh.
² Department of Community Medicine, Mymensingh Medical College, Mymensingh, Bangladesh.
³ Faculty of Veterinary Science, Department of Microbiology and Hygiene, Bangladesh Agricultural University, Mymensingh, Bangladesh.
⁴ Department of Microbiology, Netrokona Medical College, Netrokona, Bangladesh.
⁵ Laboratory of Epidemiology & Artificial Intelligence, Faculty of Public Health, University of Thessaly, Volos, Greece.
⁶ Sydney School of Veterinary Science, The University of Sydney, Camden, New South Wales, Australia.

Abstract

Background: The study was aimed to estimate the true prevalence of human tuberculosis (TB); identify risk factors and clinical symptoms of TB; and detect rifampicin (RIF) sensitivity in three study areas of Bangladesh.

Methods: The cross-sectional study was conducted in three Bangladesh districts during 2018. Potential risk factors, clinical symptoms, and comorbidities were collected from 684 TB suspects. Sputum specimens were examined by LED microscopy. TB hierarchical true prevalence, risk factors and clinical symptoms were estimated and identified using a Bayesian analysis framework. Rifampicin sensitivity of M. tuberculosis (MTB) was detected by GeneXpert MTB/RIF assay.

Results: The median TB true prevalence was 14.2% (3.8; 34.5). Although overall clustering of prevalence was not found, several DOTS centers were identified with high prevalence (22.3% to 43.7%). Risk factors for TB identified (odds ratio) were age (> 25 to 45 years 2.67 (1.09; 6.99), > 45 to 60 years 3.43 (1.38; 9.19) and individuals in families/neighborhoods where a TB patient(s) has (ve) already been present (12.31 (6.79; 22.60)). Fatigue, night sweat, fever and hemoptysis were identified as important clinical symptoms. Seven of the GeneXpert MTB/RIF positive sputum specimens (65) were resistant to rifampicin.

Conclusions: About one in every seven TB suspects was affected with TB. A number of the TB patients carry multi drug resistant MTB. Hierarchical true prevalence estimation allowed identifying DOTS centers with high TB burden. Insights from this study will enable more efficient use of DOTScenters-based TB surveillance to end the TB epidemic in Bangladesh by 2035.

Publication types

Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

Adult
Bangladesh / epidemiology
Bayes Theorem
Cross-Sectional Studies
Humans
Middle Aged
Mycobacterium tuberculosis* / genetics
Rifampin / pharmacology
Rifampin / therapeutic use
Risk Factors
Sensitivity and Specificity
Sputum
Tuberculosis* / diagnosis
Tuberculosis* / drug therapy
Tuberculosis* / epidemiology
Tuberculosis, Pulmonary* / diagnosis
Tuberculosis, Pulmonary* / drug therapy
Tuberculosis, Pulmonary* / epidemiology

Substances

Rifampin

Grants and funding

This research work was funded by the United States Department of Agriculture (USDA) [Project/Grant ID: USDA2001 Section 416 (b)]. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.