LOW PREVALENCE AND INCREASED HOUSEHOLD CLUSTERING OF MYCOBACTERIUM TUBERCULOSIS INFECTION IN HIGH ALTITUDE VILLAGES IN PERU

SUSAN OLENDER New York University School of Medicine, New York, New York; Proyectos en Informatica, Salud, Medicina y Agricultura (A. B. PRISMA), Lima, Peru; University of Texas School of Medicine, Galveston, Texas; Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Department of Microbiology, School of Public Health and Health Administration and School of Medicine, Universidad Peruana Cayetano Heredia, Lima, Peru; State University of New York at Stony Brook School of Medicine, Stony Brook, New York

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MAYUKO SAITO New York University School of Medicine, New York, New York; Proyectos en Informatica, Salud, Medicina y Agricultura (A. B. PRISMA), Lima, Peru; University of Texas School of Medicine, Galveston, Texas; Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Department of Microbiology, School of Public Health and Health Administration and School of Medicine, Universidad Peruana Cayetano Heredia, Lima, Peru; State University of New York at Stony Brook School of Medicine, Stony Brook, New York

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JANE APGAR New York University School of Medicine, New York, New York; Proyectos en Informatica, Salud, Medicina y Agricultura (A. B. PRISMA), Lima, Peru; University of Texas School of Medicine, Galveston, Texas; Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Department of Microbiology, School of Public Health and Health Administration and School of Medicine, Universidad Peruana Cayetano Heredia, Lima, Peru; State University of New York at Stony Brook School of Medicine, Stony Brook, New York

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KARI GILLENWATER New York University School of Medicine, New York, New York; Proyectos en Informatica, Salud, Medicina y Agricultura (A. B. PRISMA), Lima, Peru; University of Texas School of Medicine, Galveston, Texas; Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Department of Microbiology, School of Public Health and Health Administration and School of Medicine, Universidad Peruana Cayetano Heredia, Lima, Peru; State University of New York at Stony Brook School of Medicine, Stony Brook, New York

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CHRISTIAN T. BAUTISTA New York University School of Medicine, New York, New York; Proyectos en Informatica, Salud, Medicina y Agricultura (A. B. PRISMA), Lima, Peru; University of Texas School of Medicine, Galveston, Texas; Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Department of Microbiology, School of Public Health and Health Administration and School of Medicine, Universidad Peruana Cayetano Heredia, Lima, Peru; State University of New York at Stony Brook School of Medicine, Stony Brook, New York

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ANDRES G. LESCANO New York University School of Medicine, New York, New York; Proyectos en Informatica, Salud, Medicina y Agricultura (A. B. PRISMA), Lima, Peru; University of Texas School of Medicine, Galveston, Texas; Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Department of Microbiology, School of Public Health and Health Administration and School of Medicine, Universidad Peruana Cayetano Heredia, Lima, Peru; State University of New York at Stony Brook School of Medicine, Stony Brook, New York

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PEDRO MORO New York University School of Medicine, New York, New York; Proyectos en Informatica, Salud, Medicina y Agricultura (A. B. PRISMA), Lima, Peru; University of Texas School of Medicine, Galveston, Texas; Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Department of Microbiology, School of Public Health and Health Administration and School of Medicine, Universidad Peruana Cayetano Heredia, Lima, Peru; State University of New York at Stony Brook School of Medicine, Stony Brook, New York

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LUZ CAVIEDES New York University School of Medicine, New York, New York; Proyectos en Informatica, Salud, Medicina y Agricultura (A. B. PRISMA), Lima, Peru; University of Texas School of Medicine, Galveston, Texas; Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Department of Microbiology, School of Public Health and Health Administration and School of Medicine, Universidad Peruana Cayetano Heredia, Lima, Peru; State University of New York at Stony Brook School of Medicine, Stony Brook, New York

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EVELYN J. HSIEH New York University School of Medicine, New York, New York; Proyectos en Informatica, Salud, Medicina y Agricultura (A. B. PRISMA), Lima, Peru; University of Texas School of Medicine, Galveston, Texas; Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Department of Microbiology, School of Public Health and Health Administration and School of Medicine, Universidad Peruana Cayetano Heredia, Lima, Peru; State University of New York at Stony Brook School of Medicine, Stony Brook, New York

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ROBERT H. GILMAN New York University School of Medicine, New York, New York; Proyectos en Informatica, Salud, Medicina y Agricultura (A. B. PRISMA), Lima, Peru; University of Texas School of Medicine, Galveston, Texas; Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Department of Microbiology, School of Public Health and Health Administration and School of Medicine, Universidad Peruana Cayetano Heredia, Lima, Peru; State University of New York at Stony Brook School of Medicine, Stony Brook, New York

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DOI:
https://doi.org/10.4269/ajtmh.2003.68.721
Volume/Issue:
Volume 68: Issue 6
Page(s):
721–727
Restricted access
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Anecdotal historical evidence suggests that tuberculosis was uncommon at high altitude, but whether transmission is affected by high altitude is not known. To test whether high altitude lowers infection by Mycobacterium tuberculosis, the prevalence of tuberculin skin test (TST) positivity was compared between two high altitude villages (3,340 meters [10,960 feet] and 3,500 meters [11,480 feet]) and three sea-level sites in Peru. High altitude villages had lower TST-positive prevalence rates (5.7% and 6.8%) than sea level areas (25–33%), and the difference remained significant (odds ratio = 4.5–6.0) after adjusting for age, education, bacille Calmette-Guérin vaccination, and contact with tuberculosis patients. The TST-positive individuals clustered within highland families more than within sea level families. These data suggest that prevention and control efforts targeted to families may be more effective at high altitude. The mechanism by which TST-positivity prevalence is decreased at high altitude is unknown, but may reflect relative hypoxia, low humidity, or an increased ultraviolet effect.

Author Notes

Copyright:
Copyright 2003 The American Society of Tropical Medicine 2003
Received:
01 Oct 2002
|
Accepted:
03 Mar 2003
|
Published Online:
Jun 2003
Cover The American Journal of Tropical Medicine and Hygiene
The American Journal of Tropical Medicine and Hygiene
Print ISSN:
0002-9637
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