Control measures to trace ≤ 15-year-old contacts of index cases of active pulmonary tuberculosis

Abstract

This was descriptive study carried out in a medium-sized Brazilian city. In ≤ 15-year-old contacts of index cases of active pulmonary tuberculosis, we assessed compliance with the Brazilian national guidelines for tuberculosis control. We interviewed 43 contacts and their legal guardians. Approximately 80% of the contacts were not assessed by the municipal public health care system, and only 21% underwent tuberculin skin testing. The results obtained with the Chi-square Automatic Interaction Detector method suggest that health care teams have a biased attitude toward assessing such contacts and underscore the need for training health professionals regarding tuberculosis control programs.

Spatial distribution of tuberculosis from 2002 to 2012 in a midsize city in Brazil

“…First, the number of patients identified with respiratory symptoms that could be associated with TB was relatively low, meaning that suspected cases of the disease were fewer than would be expected. Secondly, a previous study conducted by our group in the same municipality established that health workers did not follow the protocol for diagnosis for TB properly [ 13 ]. Therefore, possible explanations for the lower incidence rate of TB in the area may be under-diagnosis or under-reporting of the disease.…”

Latent tuberculosis confirmed by in vitro release of interferon gamma

“…El 16% detectado en pacientes provenientes de los servicios privados sugieren mayor vigilancia en esta población a fin de cortar la transmisión, mediante el tratamiento e identificación la fuente de contagio, porque es imposible correlacionar la concentración del IFN ɤ con el grado de infección y progresión a enfermedad activa (11,16) . En Polonia, el mejor factor predictivo de progresión a tuberculosis activa en el 36,7% de personas sin hogar y 27,2% de contacto cercano fue la detección simultánea de un IGRA positiva junto con una prueba cutánea a la tuberculina positiva (10) .…”

Immunologic-based Diagnosis of Latent Tuberculosis Among Children Younger Than 5 Years of Age Exposed and Unexposed to Tuberculosis in Tanzania

“…5 Despite the WHO's emphasis on providing TB preventive therapy, contact tracing remains a largely neglected part of TB control in high-burden countries due to lack of financial and human resources, coupled with the high costs associated with diagnostics and contact tracing itself. 6 High-income countries mostly use interferon-gamma release assay (IGRA) for TB contact tracing, which has high specificity for detecting M. tuberculosis infection but limited sensitivity, particularly in children. 7 Most TB programs in low-income countries and high TB-incidence rates use tuberculin skin test (TST) instead of IGRA, such as the ELISpot-based test (T-SPOT.TB) and the enzyme-linked immunosorbent assay (ELISA)-based test QuantiFERON-TB Gold (QFT), that are restricted to research use only in these settings.…”