Prevalence of smear-positive pulmonary tuberculosis in different ethnic groups in India: Evaluation of public health

Objective: To estimate the prevalence of pulmonary tuberculosis (TB) in a high-risk rural area of central India. Study design: Retrospective analysis of primary data. Methods: In total, 10,963 sputum smears were screened from Hindu tribes (n = 4032), Hindu non-tribal (n = 5445) and Muslim communities (n = 1486) between 2004 and 2009. Smears were recorded as positive or negative for tubercle bacilli following staining with acid-fast bacilli, in accordance with the guidelines of the World Health Organization. Age- and gender-specific prevalence rates and relative risks (RR) were calculated using Statistical Package for the Social Sciences Version 13.0. Results: The prevalence of TB was found to be significantly higher in Hindu tribes compared with Hindu castes and Muslims (P < 0.005). The overall RR of developing smear-positive disease was 1.4-fold higher (95% confidence interval 1.1-1.7; P < 0.005) in males than females in all the study groups. The highest prevalence of TB was observed in subjects aged 15-34 years. Conclusions: Hindu tribes and males of working age are still at high risk of smear-positive TB.