Individual and community level response for pulmonary tuberculosis patients in India

Background: Host-related and environment-related factors have been shown to play a role in the development of tuberculosis (TB), but few studies were carried out to identify their respective roles in Central India.Methods: This was a descriptive case control study, which was conducted at tertiary care government hospital. The duration of the study was from January 2011 to September 2013. A total of 822 sputum smear-positive TB patients were included in the study. Cases were newly detected smear positive TB patients. Two controls were recruited for each case, one within the household of the case, and one in the community.Results: Regarding host-related factors, univariate analysis by conditional logistic regression of 687 matched pairs of cases and household controls showed that TB was associated with male sex, family history of TB, smoking, alcohol, anaemia, HIV infection, and history and treatment of worm infection. In a multivariable model based on 601 matched pairs, male sex, family history of TB, smoking, and HIV infection were independent risk factors of TB. The investigation of environmental factors based on the comparison of 816 cases/community control pairs showed that the risk of TB was associated with single marital status, family history of TB and adult crowding.Conclusions: TB is a multifactorial disorder, in which environment interacts with host-related factors. This study provided useful information for the assessment of host and environmental factors of TB for the improvement of TB control activities in developing countries