Self-reported Tuberculosis in Odisha, India: The Importance of Social Group and Other Social Determinants

Description

Page: 534-540

Chodaganga Sahu¹ and Bikash Padhan² (School of Economics, University of Hyderabad, Hyderabad¹ and Department of Humanities and Social Sciences, Indian Institute of Science Education and Research, Mohali²)

The risk of tuberculosis is associated with exposure to poverty and other social determinants besides biological factors. This study investigates the prevalence of and the inequality in reported Tuberculosis cases among different socio-economic groups in Odisha, India. We have estimated the prevalence of tuberculosis in Odisha, India, according to the Socio-Economic conditions of more than 16 lakh individuals from the first updation round of Annual Health Survey (2011-12) (N=1,628,029). Multivariate logistic regression is used to examine the inequality in tuberculosis affliction and its associated covariates. The Fairlie decomposition method is employed to explore the relative contribution of different socio-economic factors for the inequality in TB-risk between the Scheduled Castes/Scheduled Tribes (SC/STs) and Non-SC/STs communities. The prevalence of tuberculosis in Odisha was found to be 162 (95% Confidence Interval (CI): 161 -163) per 100000 population. The SCs (Adjusted Odd Ratios (AOR):1.35, 95% CI:1.23 – 1.49), and STs (AOR:1.29,95% CI: 1.17-1.42), poorest (AOR:1.51, 95% CI: 1.26 – 1.81), no formal education (AOR:5.77, 95% CI: 2.96 -11.24), individuals reported a higher likelihood of TB after controlling the other covariates. The results from the Fairlie decomposition analysis reveal that education and wealth are the prime determinants for widening the gap in TB-risk between SC/STs and Non-SC/STs. Successful elimination of TB requires tackling the question of social determinants in the prevalence and risk of TB by addressing the deeply ingrained social and economic inequality. This study may be beneficial for framing public health action for disadvantaged social classes in Odisha, India.