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

Who

• Participants: Children residing in orphanages

• Sample size: 175 children initially screened; 172 included in analysis

• Age: <18 years (median age 15 years; only 1 child <5 years)

• Sex: Case group: 46.1% male, 53.1% female

• Exclusions: Children with prior TB infection or TB treatment

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What

• Focus: Prevalence (occurrence) and risk factors of tuberculosis (TB) infection among orphanage children

• Findings:

  • 49 children (28.0%) had positive tuberculin test results and were classified as TB infection cases

  • No child had clinically confirmed TB disease

  • Environmental factors were strongly associated with TB infection

• Conclusions:

  • TB infection among orphanage children in Bali is high

  • Poor ventilation and indoor humidity are the main independent risk factors

• Implications:

  • Improving indoor environmental conditions in orphanages is critical for TB prevention

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When

• Study period: March to August 2022

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Where

• Setting: 12 orphanages in Bali, Indonesia

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Why

• There is a lack of accurate data on TB infection prevalence among orphanage children in Indonesia

• TB burden in orphanages, especially in Bali, is poorly understood despite high vulnerability

• Accurate screening is needed to prevent TB transmission, morbidity, and mortality

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How

• Study design: Observational-analytic case–control study

• Sampling: Consecutive sampling

• TB assessment:

  • TB scoring system (clinical signs, history, and chest X-ray)

  • Tuberculin skin test (≥10 mm induration = positive)

• Measurements:

  • Demographics, nutrition (BMI-for-age, height-for-age using World Health Organization standards), TB contact history, BCG status

  • Environmental factors: room density, ventilation/room area ratio, humidity, lighting

• Analysis:

  • Bivariate and multivariate analysis of risk factors

• Key independent risk factors:

• Ventilation/room area ratio <10% (OR 2.7; p=0.011)

• Indoor humidity ≥73% (OR 3.9; p=0.001)

Source: Clearesta, K.E., Mayangsari, A.S.M., Wati, D.K., Purniti, N.P.S., Suwarba, I.G.N.M. and Artana, I.W.D., 2024. Occurence and risk factors of tuberculosis infection in orphanage children in Bali. Paediatrica Indonesiana, 64(2), pp.152-9.