The Prevalence of Self-Reported Tuberculosis in the Andaman and Nicobar Islands, India: Evidence from the NFHS-IV and V
Abstract
1. Introduction
2. Materials and Methods
2.1. Source of Data
2.2. Data Collection
2.3. Data Analysis
3. Results
3.1. Study Population
3.2. Prevalence of TB
3.3. Factors Associated with Self-Reported TB
4. Discussion
5. Limitations
6. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
- WHO. Global Tuberculosis Report 2022; World Health Organization: Geneva, Switzerland, 2022; p. 68. Available online: https://www.who.int/publications/i/item/9789240061729 (accessed on 1 June 2023).
- Trauer, J.M.; Dodd, P.J.; Gomes, M.G.M.; Gomez, G.B.; Houben, R.M.G.J.; McBryde, E.S.; Melsew, Y.A.; Menzies, N.A.; Arinaminpathy, N.; Shrestha, S.; et al. The Importance of Heterogeneity to the Epidemiology of Tuberculosis. Clin. Infect. Dis. 2019, 69, 159–166. [Google Scholar] [CrossRef]
- CTD. RNTCP National Strategic Plan for TB Elimination in India (2017–2025) Central TB Division; DGHS, MOHFW, Government of India: New Delhi, India, 2017; pp. 108–110. [Google Scholar]
- WHO. Implementing the WHO Stop TB Strategy: A Handbook for National Tuberculosis Control Programmes; ANNEX, Strategy for the Control and Elimination of Tuberculosis; World Health Organization: Geneva, Switzerland, 2008. Available online: https://www.ncbi.nlm.nih.gov/books/NBK310760/ (accessed on 1 June 2023).
- Begum, S. A case study of the health status of the three districts of andaman and nicobar islands a union territory of India. HSSR 2019, 7, 911–920. [Google Scholar] [CrossRef]
- National TB Prevalence Survey in India (2019–2021); Ministry of Health & Family Welfare-Government of India: New Delhi, India, 2019; p. 212. Available online: https://tbcindia.gov.in/showfile.php?lid=3659 (accessed on 5 September 2023).
- Andaman & Nicobar, TB Elimination Mission: Principles, Strategies and Activities; National TB Elimination Programme, A & N Islands: New Delhi, India, 2023; p. 63. Available online: https://tbcindia.gov.in/WriteReadData/ANTBEliminationMissionDocument.pdf (accessed on 1 June 2023).
- Siahaan, E.S.; Bakker, M.I.; Pasaribu, R.; Khan, A.; Pande, T.; Hasibuan, A.M.; Creswell, J. Islands of Tuberculosis Elimination: An Evaluation of Community-Based Active Case Finding in North Sumatra, Indonesia. Trop. Med. Infect. Dis. 2020, 5, 163. [Google Scholar] [CrossRef]
- De Vries, S.G.; Cremers, A.L.; Heuvelings, C.C.; Greve, P.F.; Visser, B.J.; Bélard, S.; Janssen, S.; Spijker, R.; Shaw, B.; Hill, R.; et al. Barriers and Facilitators to the Uptake of Tuberculosis Diagnostic and Treatment Services by Hard-to-Reach Populations in Countries of Low and Medium Tuberculosis Incidence: A Systematic Review of Qualitative Literature. Lancet Infect. Dis. 2017, 17, e128–e143. [Google Scholar] [CrossRef] [PubMed]
- Arinaminpathy, N.; Batra, D.; Khaparde, S.D.; Vualnam, T.; Maheshwari, N.; Sharma, L.; Nair, S.A.; Dewan, P. The Number of Privately Treated Tuberculosis Cases in India: An Estimation from Drug Sales Data. Lancet Infect. Dis. 2016, 16, 1255–1260. [Google Scholar] [CrossRef] [PubMed]
- TRIBAL TB INITIATIVE: Improving the Cascade of TB Care and Support Services among Tribal Populations in India; Ministry of Health and Family Welfare Government of India: New Delhi, India; Ministry of Tribal Affairs Government of India: New Delhi, India, March 2022. Available online: https://tbcindia.gov.in/WriteReadData/l892s/5883826004Tribal%20TB%20Initiative.pdf (accessed on 5 June 2023).
- Thomas, B.E.; Thiruvengadam, K.; Vedhachalam, C.; Rao, V.; Vijayachari, P.; Rajiv, Y.; Bansal, A.K.; Indira Krishna, A.K.; Joseph, A.; Hussain, T.; et al. Prevalence of Pulmonary Tuberculosis among the Tribal Populations in India. PLoS ONE 2021, 16, e0251519. [Google Scholar] [CrossRef]
- National Family Health Survey (NFHS-4), 2015-16: India; International Institute for Population Sciences (IIPS): Mumbai, India; ICF: Calverton, MD, USA, 2017.
- National Family Health Survey (NFHS-5), 2019-21: India; International Institute for Population Sciences (IIPS): Mumbai, India; ICF: Calverton, MD, USA, 2021.
- Pardeshi, G.; DeLuca, A.; Agarwal, S.; Kishore, J. Tuberculosis Patients Not Covered by Treatment in Public Health Services: Findings from India’s National Family Health Survey 2015–16. Trop. Med. Int. Health 2018, 23, 886–895. [Google Scholar] [CrossRef]
- Notification of Tuberculosis 2012 Press Information Bureau, Government of India; National Informatics Centre: New Delhi, India, 2015; Available online: http://pib.nic.in/newsite/erelease.aspx?relid=83486 (accessed on 1 June 2023).
- Floyd, S.; Sismanidis, C.; Yamada, N.; Daniel, R.; Lagahid, J.Y.; Mecatti, F.; Vianzon, R.; Bloss, E.; Edine, W.; Tiemersma, E.W.; et al. Analysis of Tuberculosis Prevalence Surveys: New Guidance on Best-Practice Methods. Emerg. Themes Epidemiol. 2013, 10, 10. [Google Scholar] [CrossRef] [PubMed]
- Dhamnetiya, D.; Patel, P.; Jha, R.P.; Shri, N.; Singh, M.; Bhattacharyya, K. Trends in Incidence and Mortality of Tuberculosis in India over Past Three Decades: A Joinpoint and Age-Period-Cohort Analysis. BMC Pulm. Med. 2021, 21, 375. [Google Scholar] [CrossRef]
- Sathiyamoorthy, R.; Kalaivani, M.; Aggarwal, P.; Gupta, S. Prevalence of Pulmonary Tuberculosis in India: A Systematic Review and Meta-Analysis. Lung India 2020, 37, 45. [Google Scholar] [CrossRef] [PubMed]
- Singh, S.K.; Kashyap, G.C.; Puri, P. Potential Effect of Household Environment on Prevalence of Tuberculosis in India: Evidence from the Recent Round of a Cross-Sectional Survey. BMC Pulm. Med. 2018, 18, 66. [Google Scholar] [CrossRef]
- Rao, V.G.; Bhat, J.; Yadav, R.; Gopalan, G.P.; Nagamiah, S.; Bhondeley, M.K.; Anjinappa, S.M.; Ramchandra, J.; Chadha, V.K.; Wares, F. Prevalence of Pulmonary Tuberculosis—A Baseline Survey In Central India. PLoS ONE 2012, 7, e43225. [Google Scholar] [CrossRef]
- Singh, H.; Ramamohan, V. A Model-Based Investigation into Urban-Rural Disparities in Tuberculosis Treatment Outcomes under the Revised National Tuberculosis Control Programme in India. PLoS ONE 2020, 15, e0228712. [Google Scholar] [CrossRef]
- Thomas, B.E.; Adinarayanan, S.; Manogaran, C.; Swaminathan, S. Pulmonary Tuberculosis among Tribals in India: A Systematic Review & Meta-Analysis. Indian J. Med. Res. 2015, 141, 614–623. [Google Scholar] [CrossRef]
- Rao, V.G.; Bhat, J.; Yadav, R.; Sharma, R.K.; Muniyandi, M. Declining Tuberculosis Prevalence in Saharia, a Particularly Vulnerable Tribal Community in Central India: Evidences for Action. BMC Infect. Dis. 2019, 19, 180. [Google Scholar] [CrossRef] [PubMed]
- Das, A. Aiming for a Tuberculosis-Free India: Perspective of a Highly Endemic Particularly Vulnerable Tribal Group (PVTG). Clin. Epidemiol. Glob. Health 2021, 9, 69–70. [Google Scholar] [CrossRef]
- Bhat, J.; Rao, V.G.; Gopi, P.G.; Yadav, R.; Selvakumar, N.; Tiwari, B.; Gadge, V.; Bhondeley, M.K.; Wares, F. Prevalence of Pulmonary Tuberculosis amongst the Tribal Population of Madhya Pradesh, Central India. Int. J. Epidemiol. 2009, 38, 1026–1032. [Google Scholar] [CrossRef] [PubMed][Green Version]
- Imam, F.; Sharma, M.; Obaid Al-Harbi, N.; Rashid Khan, M.; Qamar, W.; Iqbal, M.; Daud Ali, M.; Ali, N.; Khalid Anwar, M. The Possible Impact of Socioeconomic, Income, and Educational Status on Adverse Effects of Drug and Their Therapeutic Episodes in Patients Targeted with a Combination of Tuberculosis Interventions. Saudi J. Biol. Sci. 2021, 28, 2041–2048. [Google Scholar] [CrossRef] [PubMed]
- Pathak, D.; Vasishtha, G.; Mohanty, S.K. Association of Multidimensional Poverty and Tuberculosis in India. BMC Public Health 2021, 21, 2065. [Google Scholar] [CrossRef] [PubMed]
- Purty, A. Detect–Treat–Prevent–Build: Strategy for TB Elimination in India by 2025. Indian J. Community Med. 2018, 43, 1. [Google Scholar] [CrossRef]
- Kumari, R.; Bhattacharyya, S. Pandemics and Patients with Chronic Diseases: A Study on the Health Care System in Port Blair, Andaman and Nicobar Islands. J. Anthropol. Surv. India 2022, 71, 220–235. [Google Scholar] [CrossRef]
- Arinaminpathy, N.; Nandi, A.; Vijayan, S.; Jha, N.; Nair, S.A.; Kumta, S.; Dewan, P.; Rade, K.; Vadera, B.; Rao, R.; et al. Engaging with the Private Healthcare Sector for the Control of Tuberculosis in India: Cost and Cost-Effectiveness. BMJ Glob. Health 2021, 6, e006114. [Google Scholar] [CrossRef] [PubMed]
NFHS-IV | NFHS-V | |||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
Self-Reported TB | Crude Prevalence (95% CI) | Adjusted TB Prevalence (95% CI) | Self-Reported TB | Crude Prevalence (95% CI) | Adjusted TB Prevalence (95% CI) | |||||||
Popn-10,288 | TB-80 | Popn-9388 | TB-34 | |||||||||
N | % | n | % | N | % | n | % | |||||
Age Group (in Years) | ||||||||||||
0 to 14 | 2451 | 23.9% | 3 | 9.0% | 122 (25, 357) | 234 (19, 967) | 1963 | 20.9% | 2 | 5.9% | 102 (12, 368) | 62 (5, 260) |
15 to 24 | 1684 | 16.7% | 11 | 25.4% | 653 (327, 1166) | 946 (329, 2116) | 1260 | 13.4% | 7 | 20.6% | 556 (224, 1141) | 315 (76, 855) |
25 to 34 | 1900 | 19.8% | 15 | 23.3% | 789 (443, 1299) | 723 (310, 1428) | 1660 | 17.7% | 5 | 14.7% | 301 (98, 702) | 79 (26, 182) |
35 to 44 | 1692 | 16.4% | 17 | 19.2% | 1005 (586, 1604) | 718 (250, 1606) | 1555 | 16.6% | 3 | 8.8% | 193 (40, 563) | 53 (11, 154) |
45 to 54 | 1243 | 11.7% | 10 | 6.6% | 805 (386, 1475) | 345 (100, 851) | 1316 | 14.0% | 6 | 17.6% | 456 (167, 990) | 581 (140, 1570) |
55 to 64 | 794 | 7.1% | 14 | 7.5% | 1763 (967, 2941) | 643 (199, 1535) | 998 | 10.6% | 5 | 14.7% | 501 (163, 1165) | 219 (54, 588) |
≥65 | 524 | 4.5% | 10 | 9.0% | 1908 (919, 3482) | 1230 (359, 3017) | 636 | 6.8% | 6 | 17.6% | 943 (347, 2042) | 616 (142, 1706) |
Gender | ||||||||||||
Male | 5253 | 50.5% | 53 | 52.9% | 1009 (757, 1318) | 642 (370, 1034) | 4800 | 51.1% | 18 | 52.9% | 375 (222, 592) | 219 (101, 414) |
Female | 5035 | 49.5% | 27 | 47.1% | 536 (354, 779) | 588 (310, 1011) | 4588 | 48.9% | 16 | 47.1% | 349 (199, 566) | 223 (85, 473) |
Residence Area | ||||||||||||
Urban | 1692 | 42.0% | 11 | 49.9% | 650 (325, 1160) | 724 (362, 1292) | 1952 | 20.8% | 2 | 5.9% | 102 (12, 370) | 107 (13, 386) |
Rural | 8596 | 58.1% | 69 | 50.2% | 803 (625, 1015) | 535 (349, 785) | 7436 | 79.2% | 32 | 94.1% | 430 (295, 607) | 289 (153, 496) |
Tribal Population | ||||||||||||
Non-Tribes | 7156 | 93.2% | 32 | 81.6% | 447 (306, 631) | 539 (338, 815) | 6822 | 72.7% | 9 | 26.5% | 132 (60, 250) | 164 (67, 334) |
Tribes | 3132 | 6.8% | 48 | 18.4% | 1533 (1132, 2027) | 1653 (932, 2703) | 2566 | 27.3% | 25 | 73.5% | 974 (631, 1435) | 801 (493, 1229) |
Education | ||||||||||||
No Education | 3502 | 31.9% | 25 | 30.3% | 714 (463, 1052) | 587 (273, 1098) | 3087 | 32.9% | 15 | 44.1% | 486 (272, 800) | 260 (103, 543) |
Primary | 4953 | 47.0% | 44 | 55.9% | 888 (646, 1191) | 731 (412, 1198) | 4419 | 47.1% | 12 | 35.3% | 272 (140, 474) | 185 (60, 433) |
Secondary or Higher | 1833 | 21.2% | 11 | 13.8% | 600 (300, 1071) | 400 (132, 923) | 1882 | 20.0% | 7 | 20.6% | 372 (150, 765) | 237 (56, 648) |
Wealth Index | ||||||||||||
Poorest/Poorer | 5441 | 40.1% | 53 | 57.9% | 974 (730, 1272) | 889 (513, 1432) | 5034 | 53.6% | 24 | 70.6% | 477 (306, 709) | 241 (131, 407) |
Middle | 2236 | 19.9% | 17 | 23.3% | 760 (444, 1215) | 718 (315, 1395) | 1749 | 18.6% | 5 | 14.7% | 286 (93, 666) | 278 (43, 914) |
Richer/Richest | 2611 | 40.0% | 10 | 18.8% | 383 (184, 703) | 289 (104, 638) | 2605 | 27.7% | 5 | 14.7% | 192 (62, 447) | 172 (42, 462) |
Districts | ||||||||||||
Nicobars | 3952 | 7.0% | 52 | 15.1% | 1316 (984, 1722) | 1322 (861, 1940) | 3223 | 34.3% | 25 | 73.5% | 776 (503, 1143) | 852 (535, 1286) |
North and Middle | 3073 | 26.8% | 8 | 11.4% | 260 (112, 512) | 265 (104, 552) | 3014 | 32.1% | 4 | 11.8% | 133 (36, 339) | 127 (22, 400) |
South | 3263 | 66.2% | 20 | 73.5% | 613 (375, 945) | 681 (404, 1074) | 3151 | 33.6% | 5 | 14.7% | 159 (52, 370) | 180 (57, 425) |
Overall | ||||||||||||
10,288 | 100.0% | 80 | 0.6% | 778 (617, 967) | 615 (418, 873) | 9388 | 100.0% | 34 | 0.4% | 362 (251, 506) | 221 (122, 367) |
Factors | NFHS–IV | NFHS-V | ||||||||
---|---|---|---|---|---|---|---|---|---|---|
Public | Private | p-Value | Public | Private | p-Value | |||||
N | % | n | % | n | % | n | % | |||
Age Group (in Years) | ||||||||||
0 to 14 | 2458 | 24.0% | 37 | 21.8% | 0.838 | 1932 | 20.9% | 31 | 14.1% | 0.089 |
15 to 24 | 1708 | 16.8% | 23 | 13.1% | 1215 | 13.9% | 45 | 20.5% | ||
25 to 34 | 1894 | 19.7% | 42 | 21.9% | 1625 | 18.9% | 35 | 16.4% | ||
35 to 44 | 1687 | 16.4% | 28 | 16.9% | 1520 | 16.4% | 35 | 15.8% | ||
45 to 54 | 1229 | 11.6% | 22 | 13.0% | 1277 | 13.5% | 39 | 16.7% | ||
55 to 64 | 787 | 7.1% | 15 | 8.0% | 976 | 10.1% | 22 | 10.4% | ||
≥65 | 523 | 4.4% | 9 | 5.3% | 622 | 6.3% | 14 | 6.1% | ||
Gender | ||||||||||
Male | 5239 | 50.6% | 87 | 47.9% | 0.279 | 4692 | 51.5% | 108 | 48.5% | 0.223 |
Female | 5047 | 49.4% | 89 | 52.1% | 4475 | 48.5% | 113 | 51.5% | ||
Residence Area | ||||||||||
Urban | 1569 | 40.4% | 134 | 83.1% | <0.001 | 1783 | 35.4% | 169 | 77.7% | <0.001 |
Rural | 8717 | 59.6% | 42 | 16.9% | 7384 | 64.6% | 52 | 22.3% | ||
Tribal Population | ||||||||||
Non-Tribes | 7127 | 93.1% | 172 | 97.4% | 0.300 | 6613 | 90.9% | 209 | 95.1% | 0.377 |
Tribes | 3159 | 7.0% | 4 | 2.6% | 2554 | 9.2% | 12 | 5.0% | ||
Education | ||||||||||
No Education | 3511 | 32.1% | 45 | 24.8% | 0.024 | 3039 | 32.0% | 48 | 21.9% | <0.001 |
Primary | 4962 | 47.2% | 69 | 42.1% | 4355 | 46.5% | 64 | 28.5% | ||
Secondary or Higher | 1813 | 20.7% | 62 | 33.0% | 1773 | 21.5% | 109 | 49.6% | ||
Wealth Index | ||||||||||
Poorest/Poorer | 5506 | 41.2% | 25 | 11.3% | 0.007 | 5021 | 41.6% | 13 | 6.1% | <0.001 |
Middle | 2221 | 19.8% | 38 | 21.6% | 1712 | 20.2% | 37 | 17.1% | ||
Richer/Richest | 2559 | 39.0% | 113 | 67.1% | 2434 | 38.3% | 171 | 76.9% | ||
Districts | ||||||||||
Nicobars | 3994 | 7.2% | 1 | 0.0% | <0.001 | 3223 | 8.8% | 0 | 0.0% | <0.001 |
North and Middle Andaman | 3148 | 27.8% | 4 | 1.0% | 3007 | 30.6% | 7 | 1.8% | ||
South Andaman | 3144 | 65.0% | 171 | 98.9% | 2937 | 60.6% | 214 | 98.2% | ||
Self-reported TB Disease | ||||||||||
Non-TB | 10,207 | 99.4% | 175 | 99.4% | 0.943 | 9134 | 99.8% | 220 | 99.5% | 0.432 |
TB | 79 | 0.6% | 1 | 0.7% | 33 | 0.2% | 1 | 0.5% | ||
TB Treatment Service Providers | ||||||||||
None/No treatment | 2 | 7.5% | 0 | 0.0% | 0.978 | 3 | 12.1% | 0 | 0.0% | 0.003 |
Yes, public sector only | 74 | 84.4% | 1 | 100.0% | 29 | 86.3% | 0 | 0.0% | ||
Yes, private sector only | 1 | 4.0% | 0 | 0.0% | 0 | 0.0% | 1 | 100.0% | ||
Yes, both sectors | 2 | 4.1% | 0 | 0.0% | 1 | 1.6% | 0 | 0.0% | ||
Overall | ||||||||||
10,286 | 96.5% | 176 | 3.6% | 9167 | 95.7% | 221 | 4.3% |
Disclaimer/Publisher’s Note: The statements, opinions and data contained in all publications are solely those of the individual author(s) and contributor(s) and not of MDPI and/or the editor(s). MDPI and/or the editor(s) disclaim responsibility for any injury to people or property resulting from any ideas, methods, instructions or products referred to in the content. |
© 2023 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
Share and Cite
Thiruvengadam, K.; Krishnan, R.; Muniyandi, M. The Prevalence of Self-Reported Tuberculosis in the Andaman and Nicobar Islands, India: Evidence from the NFHS-IV and V. Trop. Med. Infect. Dis. 2023, 8, 464. https://doi.org/10.3390/tropicalmed8100464
Thiruvengadam K, Krishnan R, Muniyandi M. The Prevalence of Self-Reported Tuberculosis in the Andaman and Nicobar Islands, India: Evidence from the NFHS-IV and V. Tropical Medicine and Infectious Disease. 2023; 8(10):464. https://doi.org/10.3390/tropicalmed8100464
Chicago/Turabian StyleThiruvengadam, Kannan, Rajendran Krishnan, and Malaisamy Muniyandi. 2023. "The Prevalence of Self-Reported Tuberculosis in the Andaman and Nicobar Islands, India: Evidence from the NFHS-IV and V" Tropical Medicine and Infectious Disease 8, no. 10: 464. https://doi.org/10.3390/tropicalmed8100464
APA StyleThiruvengadam, K., Krishnan, R., & Muniyandi, M. (2023). The Prevalence of Self-Reported Tuberculosis in the Andaman and Nicobar Islands, India: Evidence from the NFHS-IV and V. Tropical Medicine and Infectious Disease, 8(10), 464. https://doi.org/10.3390/tropicalmed8100464