Abstract
BACKGROUND: Tuberculosis (TB) in adolescents is distinct from both childhood and adult TB, particularly in terms of risk factors; however, national-level data assessing these factors in adolescents remain limited despite growing attention to the issue. This study aims to identify factors associated with TB among individuals aged 10 to 18 years. METHODS: This study leverages data from the National Family Health Survey (NFHS-5) conducted in India during the year 2019-2021. A total of 479,674 adolescents were included. We employ a generalized linear mixed-effects logistic regression model to examine the association between household, environmental, demographic and behavioral factors and self-reported TB status among adolescents. RESULTS: A total of 363 adolescents reported having TB. The results show that adolescents who are male (aOR = 0.735, p < 0.001), living in a nuclear family (aOR = 0.782, p < 0.001), residing in a household without TB cases (aOR = 0.17, p < 0.001), using a traditional mud stove or chullah (aOR = 0.279, p < 0.001), do not have air conditioning or a cooler (aOR = 0.405, p < 0.001), do not use tobacco (aOR = 0.766, p < 0.001), and do not consume alcohol (aOR = 0.912, p < 0.001) have lower odds of TB. Conversely, older age (aOR = 1.136, p < 0.001), absence of a separate kitchen (aOR = 1.395, p < 0.001), belonging to poor (aOR = 2.787, p < 0.005) or middle-income households (aOR = 2.662, p < 0.001), and living in households without cattle (aOR = 1.489, p < 0.001) are associated with higher odds of TB. CONCLUSIONS: Using nationally representative NFHS data, this study identifies multiple household, socioeconomic, and behavioral factors associated with TB among adolescents in India. These findings highlight the need for targeted TB prevention strategies that address household conditions, socio-economic disparities, and adolescent health behaviors.