Determinants of tuberculosis in a rural Nigerian community hosting a DOT centre: a case–control study

Tuberculosis (TB) caused by Mycobacterium tuberculosis remains a major health problem in Nigeria despite the expansion of Directly Observed Treatment (DOT) centres. The persistence of TB in communities hosting TB centre highlights the need to address underlying host vulnerabilities and environmental conditions that continue to drive the disease transmission and lead to poor health outcomes in such communities. This study investigated the host-related and environmental determinants of Tuberculosis (TB) in Ilora, a community hosting a DOT centre. A case-control study was carried out among TB patients attending the DOT centre, patient relations, and community controls. Socio-demographic characteristics, host-related factors, and environmental determinants were collected using structured questionnaires and analyzed using IBM Statistical Product and Service Solutions (SPSS) version 20. Descriptive and inferential statistics were carried out at 5% level of significance. The study involved 117 TB patients, 117 Household controls, and 104 community controls. Over half of the respondents were males, 186 (55%), and over one-quarter, 91(26.9%) were between 21 and 30 years. For host-related factors, TB was found to be significantly associated with, personal history of asthma, diabetes, and tobacco use (aOR: 1,53, 3.17, and 9.32), respectively. Major environmental determinants of TB were: living in tenement housing type, family size > 6, presence of a factory near the house, and presence of TB patient in the house (aOR: 8.58, 3.32, 2.45, 2.45, 2.81), respectively, at P < 0.05. Addressing host and environmental determinants, as well as DOT provision, is essential to reducing the TB burden.