In:
PLOS ONE, Public Library of Science (PLoS), Vol. 16, No. 5 ( 2021-5-14), p. e0251806-
Abstract:
International and internal migration are recognized risk factors for tuberculosis (TB). Geographic mobility, including travel for work, education, or personal reasons, may also play a role in TB transmission, but this relationship is poorly defined. We aimed to define geographic mobility among participants in facility- and community-based TB case finding in Kampala, Uganda, and to assess associations between mobility, access to care, and TB disease. Methods We included consecutive individuals age ≥15 years diagnosed with TB disease through either routine health facility practices or community-based case finding (consisting of door-to-door testing, venue-based screening, and contact investigation). Each case was matched with one (for community-based enrollment) or two (health facility enrollment) TB-negative controls. We conducted a latent class analysis (LCA) of eight self-reported characteristics to identify and define mobility; we selected the best-fit model using Bayesian Information Criterion. We assessed associations between mobility and TB case status using multivariable conditional logistic regression. Results We enrolled 267 cases and 432 controls. Cases were more likely than controls to have been born in Kampala (p 〈 0.001); there was no difference between cases and controls for remaining mobility characteristics. We selected a two-class LCA model; the “mobile” class was perfectly correlated with a single variable: travel ( 〉 3 km) from residence ≥2 times per month. Mobility was associated with a 28% reduction in odds of being a TB case (adjusted matched odds ratio 0.72 [95% confidence interval 0.49, 1.06]). Conclusion Frequency of out-of-neighborhood travel is an easily measured variable that correlates closely with predicted mobility class membership. Mobility was associated with decreased risk of TB disease; this may be in part due to the higher socioeconomic status of mobile individuals in this population. However, more research is needed to improve assessment of mobility and understand how mobility affects disease risk and transmission.
Type of Medium:
Online Resource
ISSN:
1932-6203
DOI:
10.1371/journal.pone.0251806
DOI:
10.1371/journal.pone.0251806.g001
DOI:
10.1371/journal.pone.0251806.g002
DOI:
10.1371/journal.pone.0251806.t001
DOI:
10.1371/journal.pone.0251806.t002
DOI:
10.1371/journal.pone.0251806.t003
DOI:
10.1371/journal.pone.0251806.t004
DOI:
10.1371/journal.pone.0251806.s001
DOI:
10.1371/journal.pone.0251806.s002
DOI:
10.1371/journal.pone.0251806.s003
DOI:
10.1371/journal.pone.0251806.s004
DOI:
10.1371/journal.pone.0251806.s005
DOI:
10.1371/journal.pone.0251806.s006
DOI:
10.1371/journal.pone.0251806.s007
DOI:
10.1371/journal.pone.0251806.s008
DOI:
10.1371/journal.pone.0251806.s009
DOI:
10.1371/journal.pone.0251806.s010
DOI:
10.1371/journal.pone.0251806.r001
DOI:
10.1371/journal.pone.0251806.r002
DOI:
10.1371/journal.pone.0251806.r003
DOI:
10.1371/journal.pone.0251806.r004
Language:
English
Publisher:
Public Library of Science (PLoS)
Publication Date:
2021
detail.hit.zdb_id:
2267670-3
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