Tuberculosis associated with household crowding in a developed country
Abstract
Background: Tuberculosis (TB) remains an important infectious disease in New Zealand (NZ) and globally, but risk factors for transmission are still poorly understood. This research aimed to identify whether household crowding contributes to TB transmission in NZ. Methods: This ecological study used TB surveillance and census data to calculate TB incidence rates by census area unit (CAU). Census data were used to determine CAU characteristics including proportion of household crowding (a bedroom deficit of one or more), proportion of population who are migrants born in high-TB-incidence countries, median household income, and deprivation level. A negative binomial regression model was used to estimate the association between TB incidence and household crowding. Results: The analysis included 1898 notified TB cases for the 2000–4 period. Univariate analysis showed TB incidence at the CAU level was associated with household crowding, for the total population and for all ethnic and age groups. After adjusting for the covariates of household income, existing TB burden, and proportion of migrants from high-TB-incidence countries, multivariate analysis showed statistically significant associations between TB incidence and household crowding. The incidence rate ratio (IRR) was 1.05 (95% CI 1.02 to 1.08) in the total population and 1.08 (95% CI 1.04 to 1.12) for NZ-born people <40 years. Conclusion: At the CAU level, TB incidence in NZ is associated with household crowding. An individual-based study (e.g. case–control) in recently infected cases (detected by molecular epidemiology techniques) is suggested to complement these findings. Reducing or eliminating household crowding could decrease TB incidence in NZ and globally.
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Lack of ventilation in homes has been shown to contribute to the transmission of tuberculosis, and maintaining adequate indoor ventilation can effectively control TB outbreaks.
“Lack of ventilation in homes has been shown to contribute to the transmission of tuberculosis (TB) (5); maintaining adequate indoor ventilation can effectively control TB outbreaks (34).”
From Review of the Impact of Housing Quality on Inequalities in Health and Well-Being (2023) · cites this paper as [5]
Cites
Hennekens, C. H., Buring, J. E., & Mayrent, S. L. (1987) · Medical Entomology and Zoology · Cited by 2,319 · see citing works
Risk of Tuberculosis From Exposure to Tobacco Smoke
Bates, M. (2007) · Archives of Internal Medicine · doi:10.1001/archinte.167.4.335 · Cited by 553 · see citing works
Ecological effects in multi-level studies
Blakely, T. A., & Woodward, A. J. (2000) · Journal of Epidemiology and Community Health · doi:10.1136/jech.54.5.367 · Cited by 385 · see citing works
Spence, D. P., Hotchkiss, J., Williams, C. S., & Davies, P. D. O. (1993) · BMJ · doi:10.1136/bmj.307.6907.759 · Cited by 312 · see citing works
How Contagious Are Common Respiratory Tract Infections?
Musher, D. M. (2003) · New England Journal of Medicine · doi:10.1056/nejmra021771 · Cited by 290 · see citing works
Lienhardt, C., Fielding, K., Sillah, J., Bah, B., Gustafson, P., Warndorff, D. K., Palayew, M. J., Lisse, I. M., Donkor, S. A., Diallo, S., et al. (2005) · International Journal of Epidemiology · doi:10.1093/ije/dyi100 · Cited by 259 · see citing works
Tuberculosis and Race/Ethnicity in the United States: Impact of Socioeconomic Status
Cantwell, M. F., McKenna, M. T., McCray, E., et al. (1998) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/ajrccm.157.4.9704036 · Cited by 242 · see citing works
Shetty, N., Shemko, M., Vaz, M., & D′Souza, G. (2006) · PubMed · Cited by 192 · see citing works
The association of housing density, isolation and tuberculosis in Canadian First Nations communities
Clark, M. A., Riben, P., & Nowgesic, E. (2002) · International Journal of Epidemiology · doi:10.1093/ije/31.5.940 · Cited by 189 · see citing works
Risk factors for pulmonary tuberculosis in Russia: case-control study
Coker, R., McKee, M., Atun, R. A., Dimitrova, B., Dodonova, E., Kuznetsov, S., & Drobniewski, F. A. (2005) · BMJ · doi:10.1136/bmj.38684.687940.80 · Cited by 179 · see citing works
Increasing incidence of tuberculosis in England and Wales: a study of the likely causes
Bhatti, N. S., Law, M. R., Morris, J. K., Halliday, R., & Moore-Gillon, J. C. (1995) · BMJ · doi:10.1136/bmj.310.6985.967 · Cited by 158 · see citing works
Childhood tuberculosis in an urban population in South Africa: burden and risk factor
Rie, A. V., Beyers, N., Gie, R. P., et al. (1999) · Archives of Disease in Childhood · doi:10.1136/adc.80.5.433 · Cited by 147 · see citing works
Neighborhood Poverty and the Resurgence of Tuberculosis in New York City, 1984–1992
Barr, R. G., Roux, A. V. D., Knirsch, C. A., & Pablos-Méndez, A. (2001) · American Journal of Public Health · doi:10.2105/ajph.91.9.1487 · Cited by 126 · see citing works
Diel, R., Schneider, S., Meywald-Walter, K., Ruf, C., Rüsch–Gerdes, S., & Niemann, S. (2002) · Journal of Clinical Microbiology · doi:10.1128/jcm.40.2.532-539.2002 · Cited by 117 · see citing works
Socioeconomic deprivation and notification rates for tuberculosis in London during 1982-91
Mangtani, P., Jolley, D. J., Watson, J. M., & Rodrigues, L. C. (1995) · BMJ · doi:10.1136/bmj.310.6985.963 · Cited by 114 · see citing works
Risk factors for pulmonary tuberculosis: a clinic-based case control study in The Gambia
Hill, P. C., Jackson-Sillah, D., Donkor, S. A., et al. (2006) · BMC Public Health · doi:10.1186/1471-2458-6-156 · Cited by 114 · see citing works
Childhood tuberculosis in the Bronx, New York
Drucker, E., Alcabes, P., Sckell, B. M., Alcabes, P., & Bosworth, W. (1994) · The Lancet · doi:10.1016/s0140-6736(94)92588-7 · Cited by 113 · see citing works
Blackmore, T., Buchan, G. S., Grant, C. C., Grimwood, K., LENNON, D. R., Murdoch, D. R., Pierce, J., Reid, S., & Roberts, A. (2006) · Cited by 108 · see citing works
Ecological analysis of ethnic differences in relation between tuberculosis and poverty
Hawker, J. I., Bakhshi, S. S., Ali, S., & Farrington, P. (1999) · BMJ · doi:10.1136/bmj.319.7216.1031 · Cited by 90 · see citing works
Elender, F., Bentham, G., & Langford, I. H. (1998) · Social Science & Medicine · doi:10.1016/s0277-9536(97)00178-0 · Cited by 85 · see citing works
Risk factors for pulmonary tuberculosis in Estonia.
Tekkel, M., Rahu, M., Loit, H. ‐., & Baburin, A. (2002) · PubMed · Cited by 82 · see citing works
An Ecological Study of Tuberculosis Transmission in California
Myers, W. P., Westenhouse, J. L., Flood, J., et al. (2006) · American Journal of Public Health · doi:10.2105/ajph.2004.048132 · Cited by 81 · see citing works
Risk Factors for Latent Tuberculosis Infection Among Children in New York City
Saiman, L. M., Gabriel, P. S., Schulte, J., et al. (2001) · PEDIATRICS · doi:10.1542/peds.107.5.999 · Cited by 72 · see citing works
Antunes, J. L. F., & Waldman, E. A. (2001) · Social Science & Medicine · doi:10.1016/s0277-9536(00)00214-8 · Cited by 69 · see citing works
Molecular epidemiology of tuberculosis: achievements and challenges to current knowledge.
Murray, M. J., & Nardell, E. A. (2002) · PubMed · Cited by 66 · see citing works
Dwellings, crowding, and tuberculosis in Montreal
Wanyeki, I., Olson, S., Brassard, P., et al. (2006) · Social Science & Medicine · doi:10.1016/j.socscimed.2005.12.015 · Cited by 65 · see citing works
Malakmadze, N., González, I. M., Oemig, T. V., Isiadinso, I., Rembert, D., McCauley, M. M., Wand, P. J., Diem, L. A., Cowan, L., Palumbo, G. J., et al. (2005) · Clinical Infectious Diseases · doi:10.1086/427112 · Cited by 56 · see citing works
Tocque, K., Bellis, M. A., Beeching, N. J., Syed, Q., Remmington, T., & Davies, P. D. O. (2001) · European Respiratory Journal · doi:10.1183/09031936.01.00211701 · Cited by 56 · see citing works
Why the tuberculosis incidence rate is not falling in New Zealand.
Das, D. K., Baker, M. G., Venugopal, K., et al. (2006) · PubMed · Cited by 51 · see citing works
Self-citationHoughton, F. T. (2001) · New Zealand Geographer · doi:10.1111/j.1745-7939.2001.tb01602.x · Cited by 50 · see citing works
Spatial patterns of tuberculosis incidence in Cologne (Germany)
Kistemann, T., Munzinger, A., & Dangendorf, F. (2002) · Social Science & Medicine · doi:10.1016/s0277-9536(01)00216-7 · Cited by 48 · see citing works
Factors associated with the development of tuberculosis in BCG immunized children.
Tipayamongkholgul, M., Podhipak, A., Chearskul, S., et al. (2005) · PubMed · Cited by 46 · see citing works
Commentary: Socioeconomic deprivation and health and the ecological fallacy
MacRae, K. D. (1994) · BMJ · doi:10.1136/bmj.309.6967.1478 · Cited by 44 · see citing works
Risk factors for tuberculosis infection among household contacts in Bangkok, Thailand.
Tornee, S., Kaewkungwal, J., Fungladda, W., et al. (2004) · PubMed · Cited by 43 · see citing works
Tuberculosis notifications in England: the relative effects of deprivation and immigration.
Tocque, K., Doherty, M. J., Bellis, M. A., Spence, D. P., Williams, C. S., & Davies, P. D. O. (1998) · PubMed · Cited by 34 · see citing works
Deprivation, Immigration and Tuberculosis Incidence in Naples, 1996–2000
Ponticiello, A., Sturkenboom, M., Simonetti, A., et al. (2005) · European Journal of Epidemiology · doi:10.1007/s10654-005-0615-9 · Cited by 31 · see citing works
Tuberculosis epidemiology in New Zealand: 1995-2004.
Das, D. K., Baker, M. G., & Calder, L. (2006) · PubMed · Cited by 28 · see citing works
Self-citationDavidow, A. L., Mangura, B. T., Napolitano, E. C., et al. (2003) · American Journal of Public Health · doi:10.2105/ajph.93.6.1007 · Cited by 24 · see citing works
A community and workplace outbreak of tuberculosis in Hawke's Bay in 2002.
McElnay, C., Thornley, C., & Armstrong, R. (2004) · PubMed · Cited by 17 · see citing works
A prolonged outbreak of tuberculosis in the North Island
Shoemack, P. (2001) · Cited by 15 · see citing works
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Review of the Impact of Housing Quality on Inequalities in Health and Well-Being
Howden-Chapman, P., Bennett, J., Edwards, R., Jacobs, D., Nathan, K., & Ormandy, D. (2023) · Annual Review of Public Health · doi:10.1146/annurev-publhealth-071521-111836 · Cited by 153 · see citing works
Self-citationKeall, M. D., Crane, J., Baker, M. G., Wickens, K., Howden-Chapman, P., & Cunningham, M. (2012) · Environmental Health · doi:10.1186/1476-069x-11-33 · Cited by 64 · see citing works
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Riggs, L., Keall, M., Howden-Chapman, P., & Baker, M. G. (2021) · Bulletin of the World Health Organization · doi:10.2471/blt.20.263285 · Cited by 36 · see citing works
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- Authors
- Baker, M., Das, D., Venugopal, K., & Howden-Chapman, P.
- Affiliations
- University of Otago (NZ)
- Corresponding author
- Baker, M
- Venue
- Journal of Epidemiology and Community Health
- Publisher
- BMJ
- Published
- 2008-07-11
- Volume
- 62
- Issue
- 8
- Pages
- 715-721
- ISSN
- 0141-7681 (ISSN-L)
- 0143-005X
- 1470-2738
- OpenAlex
- W2162881604
- Cited by
- 155
- References
- 40
- Citations by year
- 2026: 3 · 2025: 8 · 2024: 7 · 2023: 9 · 2022: 12 · 2021: 10 · 2020: 4 · 2019: 10 · 2018: 3 · 2017: 10 · 2016: 12 · 2015: 10 · 2014: 9 · 2013: 9 · 2012: 12
- FWCI
- 5.57
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Epidemiology & Community Health (publishedVersion)
- PubMed (publishedVersion)
- Figshare (submittedVersion)
- Topics
- Health Sciences › Medicine › Infectious Diseases › Tuberculosis Research and Epidemiology
- Social Sciences › General Social Sciences › HIV, TB, and STIs Epidemiology
- Health Sciences › Medicine › Surgery › Diagnosis and treatment of tuberculosis
- Keywords
- tuberculosis, household crowding, tuberculosis transmission, tuberculosis incidence, New Zealand, socioeconomic deprivation, household income, housing conditions
- MeSH terms
- Adult, Crowding, Emigration and Immigration, Epidemiologic Methods, Family Characteristics, Female, Humans, Male, Middle Aged, New Zealand, Tuberculosis, Developed Countries
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