Prevalence and risk factors of tuberculosis infection in orphanage children in Bali, Indonesia

Background: Tuberculosis (TB) is an infectious disease that causes high morbidity and mortality worldwide. Indonesia ranks third in the most TB cases in 2020 globally. Orphanages are densely populated places with a high risk of transmission, but routine TB screening programs have yet to be carried out. This study aims to find the prevalence of tuberculosis infection and its risk factors in orphanage children. Methods: This study used a cross-sectional approach. The data collected included age, gender, nutritional status, stunting, BCG scars, and abnormalities in physical examination. History, physical examination, and tuberculin test are the screening programs performed. All children with a positive tuberculin test as an induration of 10 mm 72 hours after the tuberculin test underwent a chest X-ray. Results: We conducted tuberculosis screening for 262 children in 15 orphanages in Denpasar and Badung from July to October 2022. There is no known history of contact with active TB sufferers. No active tuberculosis infection was detected. Latent tuberculosis infection (LTBI) occurred in 57 children (21.7%), 48 (84.2%) aged 10-17 years, 28 (49.1%) were male, 54 (94.7%) had normal nutritional status, 13 (22.8%) were stunted, and no BCG scars in 28 (49.1%). No BCG scar was a risk factor for LTBI with OR 2.29 (95% CI 1.06 - 4.97; p 0.03). Conclusion: One-fifth of orphanage children suffer from LTBI, and no BCG scar was a risk factor for LTBI. TB screening should be done routinely and actively in the orphanage.