The Risk Factors for Pulmonary Tuberculosis Incidence in Ghana: A Small Matched Case-control Study

Abstract

Aims: Knowing the risk factors for tuberculosis (TB) opens up avenues for identifying target groups for intensified case finding. We aimed to identify the risk factors for pulmonary TB (PTB) incidence in a rural district in northern Ghana. Study Design: A matched case-control study. Place and Duration of Study: The Kassena Nankana West District of the Upper East Region of Ghana, between February 2019 and March 2019. Methodology: This study was conducted in 4 public health facilities. Cases were newly confirmed PTB patients aged 15 years or over, controls were age and sex matched outpatients. A pre-tested questionnaire collected information on a range of possible risk factors from participants. Conditional logistic regression identified independent risk factors for PTB incidence in a multivariable model at 95% confidence level. Results: The analysis included 174 cases and controls. Multivariable analysis showed that the risk of PTB was increased with low household monthly income (AOR=3.45; 95% CI: 1.08-10.97; P=.03), smoking (AOR=2.69; 95% CI: 1.13-6.43; P=.02) as well as household exposure to a known TB case (AOR=2.57; 95% CI: 1.08-6.10; P=.03). Conclusion: Low household monthly income, smoking, and household exposure to a known TB case were independent risk factors for PTB incidence. These factors can be used to actively screen for PTB in the population.