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Risk factors for pulmonary tuberculosis in Russia: case-control study.

Coker R, McKee M, Atun R, Dimitrova B, Dodonova E, Kuznetsov S, Drobniewski F

European Centre on Health of Societies in Transition, Department of Public Health and Policy, London School of Hygiene and Tropical Medicine, London WC1E 7HT. richard.coker@lshtm.ac.uk

OBJECTIVES: To determine risk factors for pulmonary tuberculosis in Russia. DESIGN: Case-control study of exposure to a variety of risk factors before and during the development of pulmonary tuberculosis. SETTING: Large city in Russia. PARTICIPANTS: Cases were 334 consecutive adults diagnosed as having culture confirmed pulmonary tuberculosis between 1 January 2003 and 31 December 2003. Controls were 334 individuals sampled from a validated population registry, matched for age and sex to the patients with tuberculosis. A questionnaire collected information on potential risk factors. MAIN OUTCOME MEASURES: Risk factors associated with the development of tuberculosis. RESULTS: The main risk factors for tuberculosis were low accumulated wealth (univariate odds ratio 16.70), financial insecurity (5.67), consumption of unpasteurised milk (3.58), diabetes (2.66), living with a relative with tuberculosis (2.94), being unemployed (6.10), living in overcrowded conditions (2.99), illicit drug use (8.74), and a history of incarceration in both pretrial detention centres (5.70) and prison (12.50). CONCLUSIONS: When prevalence of exposure is taken into account the most important factors in the development of pulmonary tuberculosis in Russia are exposure to raw milk and unemployment.

Published 13 January 2006 in BMJ, 332(7533): 85-7.
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