Prevalence and associated factors of tuberculosis infection among medical and veterinary undergraduate students in Makerere University, Kampala, Uganda

Abstract

Introduction: Uganda ranks 16th on the list of 22 high-burden tuberculosis (TB) countries in the world. Medical students are likely to have an increased exposure to TB infection due to their training in hospitals compared to other University students. The study was to determine the prevalence of TB infection and associated factors among undergraduate students in Makerere University College of Health Sciences (MakCHS) and those in School of Veterinary Medicine (MakSVM). Methodology: The study design was cross-sectional. 232 students in MakCHS and 250 in MakSVM were randomly selected between February and March 2011. Self administered questionnaires were used to collect socio-demographic and past medical history data. A tuberculin skin test was performed on the left forearm. An induration 10mm after 48-72 hrs was considered positive. Analysis: Comparisons of students were done with chi-square tests. Logistic regression was used to determine association between independent variables and TB infection. Odds ratios and 95% confidence intervals were determined. P–values 0.05 were considered significant. Results: The prevalence of TB infection was 44.8% (95% C.I, 38.4-51.3) in MakCHS and 35.2% (95% C.I, 29.3-41.1) in MakSVM. The difference was significant (aOR=1.7, p=0.006). The significant predictors of TB infection were male sex, history of contact with a confirmed TB case, residence at home and being a student in MakCHS. In addition, having gone to a day school in high school (aOR=2.31, p=0.034) as well as involvement in extra clinical exposure (aOR=3.39 p=0.001) predicted TB infection among students in MakCHS. No factors were significantly predicting TB infection among students in MakSVM when analyzed separately. Conclusion: Students in MakCHS have a higher prevalence of TB infection than those in MakSVM. This could be due to exposure to nosocomial TB. Protective measures like masks for coughing patients and respirators for students need to be put in place. A prospective cohort study is recommended to confirm the possible increased risk and the associated factors.