Date of Award

Summer 8-7-2018

Degree Type

Thesis

Degree Name

Master of Public Health (MPH)

Department

Public Health

First Advisor

Matthew J.Magee,PhD, MPH

Second Advisor

Unjali Gujral, PhD, MPH

Abstract

Background: Emerging epidemiologic evidence indicates tuberculosis (TB) disease may increase the risk of non-communicable disease, including cardiovascular diseases (CVD). However, limited data exists on the association between latent TB infection (LTBI) and dyslipidemia, a key precursor to CVD.

Objective: To determine the association between LTBI and dyslipidemia among newly arrived refugees to the US.

Methods: We conducted a cross-sectional study among new refugees who received care at the DeKalb County Board of Health Refugee Clinic, Atlanta, Georgia between 1st October 2013 and 31st August 2014. Eligible participants included adult refugees (age ≥21 years) who had valid QuantiFERON-TB Gold In-Tube (QFT) and blood lipid test results.

Results: Among eligible participants (n=684), the prevalence of LTBI was 31.9%. Overall 30.6% (209/684) had elevated total cholesterol, 44% (301/684) had low HDL-C, and 40.7% (276/684) had elevated TGL. Participants with LTBI had a similar prevalence of elevated total cholesterol (35.3% vs 28.3%, p-value=0.06) and elevated triglycerides (44.5% vs 38.4%, p-value=0.13) compared to participants without LTBI. Low HDL-C was also similar in participants with and without LTBI (45.7 vs 40.4%, p-value=0.64). After adjusting for age, sex, body mass index and diabetes mellitus, LTBI was non-significantly associated with elevated total cholesterol (adjusted odds ratio [aOR] 1.27; 95%CI 0.89-1.82) and elevated triglycerides (aOR 1.18; 95% CI 0.84-1.67).

Conclusion: Among recently arrived refugees in the US, we did not observe a statistically significant association between LTBI and dyslipidemia. Additional research is needed to determine mechanisms that may increase the risk of non-communicable disease in patients with TB disease and infection.

Available for download on Friday, July 26, 2019

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