Prevalence of pulmonary tuberculosis among the tribal populations in India

• DOI: 10.1371/journal.pone.0251519
• Publication Date: 2021-06-04T17:30:02Z
• Authors: Beena E. Thomas; Kannan Thiruvengadam; Chandrasekaran Ve...; Srividya A; V. G. Rao; Paluru Vijayachari; Yadav Rajiv; Raghavi V; Avi Kumar Bansal; Anil Kumar Indira...; Alex Joseph; Anil Purty J; Tahziba Hussain; Praveen Anand; Pradeep Das; K. R. John; Rekha Devi K.; Sunish P; Azhagendran S; Azger Dusthakeer; Bhat J; Vineet K. Chadha; Toteja G. S.; Dasarathy Raghunath; Madhuchhanda Das; A. M. Khan; Hapreet Kaur
• Keywords: Adult; Male; 0301 basic medicine; Adolescent; Science; Q; R; Sputum; India; Mycobacterium tuberculosis; 3. Good health; 03 medical and health sciences; Population Groups; Prevalence; Socio Behavioral; Medicine; Humans; Mass Screening; Female; Tuberculosis, Pulmonary; Research Article

ImportanceThere is no concrete evidence on the burden of TB among the tribal populations across India except for few studies mainly conducted in Central India with a pooled estimation of 703/100,000 with a high degree of heterogeneity.ObjectiveTo estimate the prevalence of TB among the tribal populations in India.Design, participants, settingA survey using a multistage cluster sampling design was conducted between April 2015 and March 2020 covering 88 villages (clusters) from districts with over 70% tribal majority populations in 17 States across 6 zones of India. The sample populations included individuals ≥15 years old.Main outcome and measuresEligible participants who were screened through an interview for symptoms suggestive of pulmonary TB (PTB); Two sputum specimens were examined by smear and culture. Prevalence was estimated after multiple imputations for non-coverage and a correction factor of 1.31 was then applied to account for non-inclusion of X-ray screening.ResultsA total of 74532 (81.0%) of the 92038 eligible individuals were screened; 2675 (3.6%) were found to have TB symptoms or h/o ATT. The overall prevalence of PTB was 432 per 100,000 populations. The PTB prevalence per 100,000 populations was highest 625 [95% CI: 496–754] in the central zone and least 153 [95% CI: 24–281] in the west zone. Among the 17 states that were covered in this study, Odisha recorded the highest prevalence of 803 [95% CI: 504–1101] and Jammu and Kashmir the lowest 127 [95% CI: 0–310] per 100,000 populations. Findings from multiple logistic regression analysis reflected that those aged 35 years and above, with BMI <18.5 Kgs /m2, h/o ATT, smoking, and/or consuming alcohol had a higher risk of bacteriologically positive PTB. Weight loss was relatively more important symptom associated with tuberculosis among this tribal populations followed by night sweats, blood in sputum, and fever.Conclusion and relevanceThe overall prevalence of PTB among tribal groups is higher than the general populations with a wide variation of prevalence of PTB among the tribal groups at zone and state levels. These findings call for strengthening of the TB control efforts in tribal areas to reduce TB prevalence through tribal community/site-specific intervention programs.