Effects of Poor Protein Intake and In-House Overcrowding On Childhood Tuberculosis in a Low-Income Bangladeshi Rural Community: A Case-Control Study

Despite a well-functioning tuberculosis (TB) control program in Bangladesh, tuberculosis (TB) contributes to an unacceptably high rate of morbidity and mortality among children. We identify the risk factors of childhood TB in a tea garden based area of Bangladesh. A case control study with 216 cases and 216 controls was conducted at seven sub-districts of Moulvibazar district in Bangladesh during the period of March 2016 to September 2016. Socio demographic and clinical data were obtained from each participant via face-to-face interview using a standard semi-structured questionnaire. Data was collected from the patient’s relative who came to the DOT’S center along with the children. Crude and multivariate logistic regression analyses were used to analyze the data. The multivariate logistic regression analysis indicated that over-crowding (>4 persons per bedroom) in the house (OR = 2.64, 95% CI = 1.66-4.25), positive history of TB in the family (OR = 1.87, CI = 1.19-2.95) and poor protein intake (OR = 1.72, CI = 1.07-2.77) are the significant risk factors for childhood TB. Besides, poor monthly income (<10000 taka) (OR = 0.58, CI = 0.30-1.10) and younger child (<10 years of age) are found nearly significant for childhood TB. To conclude, improvement in the living standard of children will help in reducing childhood TB in the community. The identified risk factors for the childhood tuberculosis reflect a complex interaction among sociodemographic conditions. The control program for the childhood TB would benefit from a collaboration of broad public health activities in improving the socio-demographic factors in the rural community.