Nutritional Risk Factors for Tuberculosis Among Adults in the United States, 1971–1992
American Journal of Epidemiology, 08/02/2012
Cegielski JP et al. – A low serum albumin level also increased the risk of tuberculosis (TB), but low vitamin A, thiamine, riboflavin, and iron status did not. A population's nutritional profile is an important determinant of its TB incidence.Methods
- NHANES I collected information on a probability sample of the US population in 1971–1975.
- Adults were followed up in 1982–1992.
- Incident TB cases were ascertained through interviews, medical records, and death certificates.
- TB incidences were compared across different levels of nutritional status after controlling for potential confounding using proportional hazards regression appropriate to the complex sample design.
- TB incidence among adults with normal body mass index was 24.7 per 100,000 person-years (95% confidence interval (CI): 13.0, 36.3).
- In contrast, among persons who were underweight, overweight, and obese, estimated TB incidence rates were 260.2 (95% CI: 98.6, 421.8), 8.9 (95% CI: 2.2, 15.6), and 5.1 (95% CI: 0.0, 10.5) per 100,000 person-years, respectively. Adjusted hazard ratios were 12.43 (95% CI: 5.75, 26.95), 0.28 (95% CI: 0.13, 0.63), and 0.20 (95% CI: 0.07, 0.62), respectively, after controlling for demographic, socioeconomic, and medical characteristics.