Occurence and risk factors of tuberculosis infection in orphanage children in Bali

Kartika Eda Clearesta; Ayu Setyorini Mestika Mayangsari; Dyah Kanya Wati; Ni Putu Siadi Purniti; I Gusti Ngurah Made Suwarba; I Wayan Dharma Artana

doi:10.14238/pi64.2.2024.152-9

Kartika Eda Clearesta Universitas Udayana
Ayu Setyorini Mestika Mayangsari Department of Child Health, Universitas Udayana Medical School/RSUP Professor IGNG Ngoerah, Denpasar, Bali
Dyah Kanya Wati Department of Child Health, Universitas Udayana Medical School/RSUP Professor IGNG Ngoerah, Denpasar, Bali
Ni Putu Siadi Purniti Department of Child Health, Universitas Udayana Medical School/RSUP Professor IGNG Ngoerah, Denpasar, Bali
I Gusti Ngurah Made Suwarba Department of Child Health, Universitas Udayana Medical School/RSUP Professor IGNG Ngoerah, Denpasar, Bali
I Wayan Dharma Artana Department of Child Health, Universitas Udayana Medical School/RSUP Professor IGNG Ngoerah, Denpasar, Bali

DOI: https://doi.org/10.14238/pi64.2.2024.152-9

Keywords: Tuberculosis, tuberculin test, orphanages, risk factors

Abstract

Background Tuberculosis (TB) is an infectious disease that is still a common threat worldwide, especially in pediatric populations. TB transmission occurs particularly when the transmitter has no obvious manifestation of the disease. There is a higher incidence of TB infection in children than in the general population, especially in high risk populations such as children in orphanages. However, the incidence of TB infection in orphaned children in Indonesia, including Bali, is unknown.

Objective To describe the incidence and risk factors for TB infection in children in orphanages in Bali.

Methods This case-control study was conducted in 12 orphanages in Bali. Subjects were divided into a case group comprised of children with TB infection, and a control group comprised of those without TB infection. TB infection was diagnosed by positive tuberculin test without clinically confirmed TB.

Results A total of 175 children were recruited as subjects. There were 49 (28.0%) children with TB infection. Bivariate analysis revealed significant associations between density, humidity, ventilation/room area ratio, and area of ??origin with TB infection. Multivariate analysis showed that ventilation/room area ratio and room humidity of ?73% were independently positive correlated with TB infection. Natural lighting and BCG scar were not significantly different between groups.

Conclusion The occurence of TB infection in children residing in orphanages in Bali is high (28%). The risk factors identified independently are lower ventilation and higher room humidity.

Author Biographies

Ayu Setyorini Mestika Mayangsari, Department of Child Health, Universitas Udayana Medical School/RSUP Professor IGNG Ngoerah, Denpasar, Bali

Dyah Kanya Wati, Department of Child Health, Universitas Udayana Medical School/RSUP Professor IGNG Ngoerah, Denpasar, Bali

References

1. CDC, UNHCR, WHO.. Tuberculosis prevention and care among refugees and other populations in humanitarian settings: an interagency field guide. Geneva: World Health Organization; 2022. ISBN 978-92-4-004208-7.
2. Dinas Kesehatan Provinsi Bali. Profil Kesehatan Provinsi Bali 2017. [cited 2023 August 1]. Available from: https://diskes.baliprov.go.id/wp-content/uploads/2019/06/Bali_Profil_2017_ds.pdf
3. Marcdante KJ, Siegel BS, Prabhu S, Prabhu S. The profession of pediatrics, In: Marcdante KJ, Kliegman R. Nelson Essentials of Pediatrics-E-Book. First South Asia Edition. Vol 1. New Delhhi: Elsevier; 2016. p. 1-4
4. Kiazyk S, Ball T. Latent tuberculosis infection: An overview. Canada Communicable Disease Report. 2017;43:62-6. DOI: https://doi.org10.14745/ccdr.v43i34a01
5. Wiharsini W. Hubungan faktor kontak, karakteritik balita dan orang tua dengan kejadian TB Paru pada balita di RSPI Prof. dr. Sulianti Saroso Tahun 2012. [thesis]. Jakarta: Universitas Indonesia; 2013.
6. Francis J. Screening for tuberculosis among orphans in a developing country. American Journal of Preventive Medicine. 2002;22:117-119. DOI: https://doi.org/10.1016/S0749-3797(01)00396-8
7. Saputra FF, Wahjuni CU, Isfandiari MA. Spatial modeling of environmental-based risk factors of tuberculosis in Bali Province: an ecological study. JBE. 2020;8:26. DOI: https://doi.org/10.20473/jbe.V8I12020.26-34
8. Madhona R, Ikhwan Z, Aminin F. Physical environment home and incidence of TB disease in Tanjungpinang District. In: Aljunid SM, Pannarunothai S, Ismail A, Nasution MKM, Aulia D, eds. Proceedings of the 1st Public Health International Conference (PHICo 2016); 2016 Dec 1-2; Medan, North Sumatera. Dordrecht: Atlantis Press; 2017. DOI: https://doi.org/10.2991/phico-16.2017.77
9. Raviglione M, O’Brien R. Tuberculosis. In: Kasper DL, Fauci AS, eds. Harrison’s Infectious Diseases. 3rd edition. New York: Mc Graw Hill; 2016. p. 596-617.
10. Shah I, Mullanfiroze K. Profile of HIV and multidrug-resistant tuberculosis in orphans living in orphanages in Mumbai, Maharashtra, India. Indian J Sex Transm Dis. 2020;41(17). DOI: https://doi.org/10.4103/ijstd.IJSTD_108_13
11. Hein N, Htun K, Oo K, Aung S, Zaw Th, Cook GM, et al. Latent tuberculosis infection among school-aged children residing at orphanage. Poster Presentation at Joint International Tropical Medicine Meeting 2017; 2017 Dec 6-8; Bangkok, Thailand.
12. Baik Y, Rickman HM, Hanrahan CF, Mmolawa L, Kitonsa PJ, Sewelana T, et al. A clinical score for identifying active tuberculosis while awaiting microbiological results: Development and validation of a multivariable prediction model in sub-Saharan Africa. Gupta-Wright A, ed. PLoS Med. 2020;17:e1003420. DOI: https://doi.org/10.1371/journal.pmed.1003420
13. Persily AK. Field measurement of ventilation rates. Indoor Air. 2016;26:97-111. DOI: https://doi.org/10.1111/ina.12193
14. Nayak S, Acharjya B. Mantoux test and its interpretation. Indian Dermatol Online J. 2012;3:2. DOI: https://doi.org/10.4103/2229-5178.93479
15. Zhang Y, Zhou J, Niu F, Donowitz JR, Haque R, Petri Jr WA, et al. Characterizing early child growth patterns of height-for-age in an urban slum cohort of Bangladesh with functional principal component analysis. BMC Pediatr. 2017;17:84. DOI: https://doi.org/10.1186/s12887-017-0831-y
16. Yustikarini K, Sidhartani M. Faktor Risiko Sakit Tuberkulosis pada Anak yang Terinfeksi Mycobacterium Tuberculosis. SP. 2016;17:136. DOI: https://doi.org/10.14238/sp17.2.2015.136-40
17. Mitinskaia L, Ivanova E, Kufakova G. Tuberculosis in children and adolescents in orphanage and boarding schools and optimization of its prevention. Probl Tuberk. 1993;5:2-4. PMID: 8295878.
18. Mamahlodi MT. Potential benefits and harms of the use of UV radiation in transmission of tuberculosis in South African health facilities. J Public Health Afr. 2019;10. DOI: https://doi.org/10.4081/jphia.2019.742
19. Apriliasari R, Hestiningsih R, Martini M, Udiyono A. Faktor yang berhubungan dengan kejadian TB paru pada anak (studi di seluruh puskesmas di Kabupaten Magelang). Jurnal Kesehatan Masyarakat. 2018;6:298-307. DOI : https://doi.org/10.14710/jkm.v6i1.19884
20. Sahadewa S, Eufemia, Edwin, Luh N, Shita. Hubungan tingkat pencahayaan, kelembaban udara, dan ventilasi udara dengan faktor risiko kejadian TB paru BTA positif di Desa Jatikalang Kecamatan Krian Kabupaten Sidoarjo. Jurnal Ilmiah Kedokteran Wijaya Kusuma. 2019;8:118-130. DOI: https://.doi.org/10.30742/jikw.v8i2.617
21. Brosch R, Gordon SV, Garnier T, Eiglmeier K, Frigui W, Valenti P, et al. Genome plasticity of BCG and impact on vaccine efficacy. Proc Natl Acad Sci U S A. 2007;104:5596-601. DOI: https://doi.org/10.1073/pnas.0700869104
22. Riani RES, Machmud PB. Correlation between BCG immunization and tuberculosis among children in 2015-2016. Sari Pediatri. 2018;19:321-327. DOI: https://doi.org/10.14238/sp19.6.2018.321-7
23. Kartasasmita CB. Epidemiologi tuberkulosis. SP. 2016;11:124. doi: https://doi.org/10.14238/sp11.2.2009.124-9
24. Sejati A, Sofiana L. Faktor-faktor terjadinya tuberkulosis. Kemas. 2015;10:122. DOI: https://doi.org/10.15294/kemas.v10i2.3372
25. Kementerian Kesehatan Republik Indonesia. Profil Kesehatan Indonesia Tahun 2019. Jakarta: Kemenkes RI; 2020. ISBN 978-602-416-977-0.