Risk of latent tuberculosis infection in children living in households with tuberculosis patients: a cross sectional survey in remote northern Lao People's Democratic Republic

Abstract

BackgroundTuberculosis is highly prevalent in Laos (289 per 100,000). We evaluated the risk of latent tuberculosis infection (LTBI) among children (0–15 years) living with tuberculosis patients in rural northern Laos.MethodsIn a cross sectional survey of 30 randomly selected villages, 72 tuberculosis patients were traced and their 317 contacts (148 were children) investigated using a questionnaire, a tuberculin skin tests (positive: > = 10 mm), a 3-day sputum examination for acid-fast bacilli (AFB), and chest radiography.ResultsNone of the 148 contact-children received prophylaxis, one had cervical tuberculosis; the risk for LTBI was 31.0%. Awareness of the infectiousness of tuberculosis was low among patients (31%) and their contacts (31%), and risky behavior was common. After multivariate logistic analysis, increased LTBI was found in children with contact with sputum positive adults (OR: 3.3, 95% CI: 1.4–7.7), patients highly positive sputum prior to treatment (AFB >2+; OR: 4.7, 95% CI: 1.7–12.3), and living in ethnic minorities (OR: 5.4, 95% CI: 2.2–13.6).ConclusionThe study supports the importance of contact tracing in remote settings with high TB prevalence. Suggestions to improve the children's detection rate, the use of existing guidelines, chemoprophylaxis of contact-children and the available interventions in Laos are discussed. Improving education and awareness of the infectiousness of TB in patients is urgently needed to reduce TB transmission.

O programa de controle da tuberculose em Pelotas/RS, Brasil: investigação de contatos intradomiciliares

“…Moreover, these children did not undergo the tests indicated in the MS for LTBI investigation. This result is a cause for concern considering findings of a study conducted in the Democratic Republic of Laos (8) on the risk of LTBI in children who live with TB patients in the same home. This study was based on 72 index cases and 317 home contacts, of which 46.7% were children between the ages of 0 and 15.…”

“…Contact tracing of TB cases is an effective and low-cost method that allows early detection of new active TB cases and the presence of latent tuberculosis infection (LTBI). This strategy interrupts the TB transmission chain and helps to reduce propagation microbes that are resistant to first-choice treatment drugs (7)(8) .…”

Risk factors for Mycobacterium tuberculosis infection among children in Greenland

“…Since contact with a known TB case has been reported to be a main predictor for MTI, 19 we further explored whether such contact modified the risk factor pattern. We determined whether a risk factor was modified by contact with a Bolette Søborg et al…”

Proporsi Infeksi Tuberkulosis dan Gambaran Faktor Risiko pada Balita yang Tinggal dalam Satu Rumah dengan Pasien Tuberkulosis Paru Dewasa

“…Proporsi infeksi TB yang kami laporkan hampir sama bila dibandingkan dengan proporsi di beberapa negara berkembang lain dengan subjek balita seperti Thailand, 13 Afrika, 14 India 1 dan Laos. 15 Namun lebih rendah apabila dibandingkan dengan negara-negara maju seperti penelitian Gessner di Amerika Serikat 16 dan Mahdi di Perancis. 17 Peningkatan infeksi TB terjadi di seluruh dunia, namun lebih banyak terjadi di negara berkembang.…”

“…Meskipun demikian, beberapa penelitian sebelumnya menyatakan tidak terdapat hubungan bermakna antara kepadatan populasi dan infeksi TB. 10,15,22,23 Perbedaan definisi operasional yang dipakai oleh berbagai penelitian tersebut menyebabkan hasil yang berbeda. Sampai saat ini belum ada konsensus yang pasti mengenai kriteria bagaimana menghitung kepadatan suatu populasi.…”