Ecological determinants of paediatric tuberculosis in India.

BACKGROUND

Paediatric tuberculosis is a surrogate indicator of ongoing TB transmission. The present study explores the relationship between the burden of paediatric TB cases and their ecological determinants in different states of India.

METHODS

Based on a conceptual model framework, an ecological record-based analysis was conducted using accessible national data from 33 Indian states and union territories. Based on the exploratory factors, negative binomial regression was performed to predict the number of paediatric tuberculosis cases.

RESULTS

There was statistically significant geospatial clustering in paediatric TB incidence among states. Notification of paediatric cases was not affected by the size of the state. The rate of paediatric tuberculosis increased significantly by a factor of 1.004 and 1.107 for each unit increase in TB incidence per 100,000 population and the proportion of stunted children. The rate dropped significantly by a factor of 0.888 for each unit increase in chemoprophylaxis proportion. The rate of paediatric tuberculosis increases by 1.004, 1.100, and 1.899 times for every unit increase in BPL %, BCG coverage, and mean household size, respectively.

CONCLUSION

Adult TB case pool, malnutrition, overcrowding, and chemoprophylaxis are important predictors of variation in paediatric cases in India.