Self-reported prevalence of tuberculosis and selected associated vulnerability factors among rural populations in six districts of India: A community-based cross-sectional study

BACKGROUND: Tuberculosis is a major public health challenge in India, contributing to one-fourth of global burden of TB disease. Comorbidities in uninfected individuals make them vulnerable to TB disease. This study estimates the self-reported prevalence of tuberculosis and selected vulnerability factors (HIV, current smoking, silicosis, occupational silica-dust exposure, diabetes mellitus and persistent cough >2 weeks) among the rural demography of six districts in India, with the aim of informing targeted active case finding under the National Tuberculosis Elimination Programme (NTEP). METHODS: The study conducted was a community-based cross-sectional survey carried out across six districts of India. Two blocks from each district was selected randomly followed by randomly selected villages under each block. A universal sampling technique was followed for including all the households of the randomly selected villages. The data were collected through a pre-tested semi-structured questionnaire schedule via face-to-face interviews at all the eligible households of the study sites. Descriptive analysis was performed, and the results were obtained in the form of frequencies and percentages. RESULTS: The ultimate data consisted of 82,636 individuals, with males at 52% and females at 47%. 77% of the study population were 15 years of age or older. This study analyzes a large dataset. The TB prevalence was around 150 per lakh of the population, while the prevalence of HIV-reactive individuals, current smokers, silicosis, occupational exposure to silica dust, diabetes mellitus and cough of greater than two weeks is found in 0.9%, 5%, 1.2%, 1.1%, 1.4% and 4% respectively. DISCUSSION AND CONCLUSION: The study highlights TB status and selected TB-vulnerable groups. The study has a large sample size, and it follows multipronged approach to study selected vulnerable population groups. This data may improve targeted active case finding among the high-risk groups as outlined by NTEP and provide better TB control strategy outcome at high TB burden settings.