TST positivity in household contacts of tuberculosis patients: a case-contact study in Malawi

Hector, Jonas; Anderson, Suzanne T.; Banda, Gertrude Mulenga; Kamdolozi, Mercy; Jefferys, Laura; Shani, Doris; Garton, Natalie J.; Mwale, A.; Jobe, Annie; Davies, Geraint R.; Sloan, Derek J.

doi:10.1186/s12879-017-2348-2

Cited by 10 publications

(10 citation statements)

References 24 publications

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“…The finding of a total of eight children with TB was close to the 10% target of total TB patients found. Other studies also reported a high level of TB case finding among children during contact investigation [27,28]. The prevalence of childhood TB among child contact tracing was also high [29].…”

Section: Discussionmentioning

confidence: 88%

The Implementation of Early Detection in Tuberculosis Contact Investigation to Improve Case Finding

Putra¹,

Kurniasari²,

Dewi³

et al. 2019

JEGH

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The early detection of Tuberculosis (TB) among TB contacts is a strategy to find TB cases in earlier stage and to stop the transmission. This study aimed to assess the implementation of early detection in TB contact investigation to improve TB case finding. This was an operational research study conducted in Badung District, Bali, Indonesia. The samples were TB contacts, identified in the period July through September (third quarter) 2017. Contacts were household members who were living and sharing a room at least for 3 months with infectious TB patients and were not previously diagnosed with TB. Data were collected through face-to-face interview using structured questionnaires and registration reviews using a checklist. We visited 124 TB patients and successfully identified 498 contacts, thus the ratio of contacts to cases is 4:1. All TB contacts were invited to participate in TB screening and evaluation program. A total of 100 (20.1%) contacts have attended at least one examination session and 41 contacts have completed all sessions. Ten TB cases were found among the contacts, of which four of them were adults (three bacteriologically confirmed and one clinically confirmed) and six were children (aged under 15 years). The positivity rate among children was higher (46.2%) compared with adults (14.3%). The positivity rate of confirmed TB among contacts with any TB symptoms was 43.8% and that without symptoms was 12.0%. The contribution of early detection in TB contact investigation to improve TB case finding was 8.1% through all TB patients. The early detection in TB contact investigation yielded additional notified cases, especially among children. A comprehensive education, covering cognitive and psychological aspect, is needed to encourage TB contacts to completely participate in early detection program until their diagnosis is confirmed.

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Section: Discussionmentioning

confidence: 88%

The Implementation of Early Detection in Tuberculosis Contact Investigation to Improve Case Finding

Putra¹,

Kurniasari²,

Dewi³

et al. 2019

JEGH

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“…This is unlikely to explain screening and treatment implementation within the cohort at IBIT, given the high percentage of patients who initiated and completed LTBI treatment. A study in Malawi identified that LTBI treatment in children was hampered by a lack of materials to perform TST and equipment to perform diagnostic x-ray examination, although a shortage of trained personnel to interpret TST results and high workload of health care professionals appeared to be the most important barriers (Hector et al, 2017). These observations strongly support the idea that optimization of TB screening and implementation of treatment for LTBI in children is crucial, particularly in those who are household contacts of those with active TB.…”

Section: Discussionmentioning

confidence: 99%

Determinants of losses in the latent tuberculosis cascade of care in Brazil: A retrospective cohort study

Araujo

Cruz

Arriaga

et al. 2020

International Journal of Infectious Diseases

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Background: The present study evaluated factors associated with losses in the latent tuberculosis infection (LTBI) cascade of care in contacts of tuberculosis (TB) patients, in a referral center from a highly endemic region in Brazil. Methods: Contacts of 1672 TB patients were retrospectively studied between 2009 and 2014. Data on TB screening by clinical investigation, radiographic examination and tuberculin skin test (TST) were extracted from medical records. Losses in the cascade of care and TB incidence within 2-year follow-up were calculated. Results: From a total of 1180 TB contacts initially identified, only 495 were examined (58% loss), and 20 were diagnosed with active TB at this stage. Furthermore, 435 persons returned for TST result interpretation and 351 ($81%) were TST positive. Among those with positive TST, 249 (73%) were treated with isoniazid for 6 months whereas 51 abandoned therapy early. Three individuals who did not receive LTBI treatment, one with incomplete treatment and another who completed treatment developed active TB. A logistic regression analysis revealed that increases in age were associated with losses in the LTBI cascade independent of other clinical and epidemiological characteristics. Conclusions: Major losses occur at initial stages and older patients are at higher risk of not completing the LTBI cascade of care.

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“…Trained laboratory technicians measured the induration after 48–72 hours, and results were subsequently validated by senior pediatricians at the study sites. A positive test result was defined as any induration greater than 10 millimeters [ 6 ].…”

Section: Methodsmentioning

confidence: 99%

Tuberculosis screening for pediatric household contacts in India: Time to adapt newer strategies under the National TB Elimination Programme!

Chawla,

Burugina Nagaraja,

Siddalingaiah

et al. 2023

PLoS ONE

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Introduction The study aimed to evaluate the effectiveness of screening pediatric household contacts (under the age of 15 years) for tuberculosis (TB) in India through verbal screening, tuberculin skin testing, and chest radiography at intervals of 0, 3, 6, 9, and 12 months. The study also aimed to determine the proportion of contacts who tested positive for TB and to describe the challenges in implementing regular follow-up. Current National TB Elimination Programme (NTEP) guidelines only require verbal screening for contacts under 6 years old at TB treatment initiation. The study aimed to fill this knowledge gap and provide valuable insights for improving TB screening in pediatric household contacts in India. Methods The study was conducted in two districts of Karnataka, India from 2021 to 2022, and utilized a cohort study design to enroll contacts of index tuberculosis (TB) cases diagnosed under the National TB Elimination Programme (NTEP). Participants were followed up at regular intervals for one year to evaluate the effectiveness of TB screening in pediatric household contacts. Results In this study, 686 pediatric household contacts were enrolled and screened for tuberculosis (TB) using verbal symptom screening, tuberculin skin testing (TST), and chest radiography. Projected figures estimated that 0.8%, 42%, and 4% of contacts would test positive for symptomatic screening, TST, and chest radiography, respectively. TB cases were detected in 2.91% (1.84–4.38) of contacts, with females above 6 years of age having a 22% higher risk of contracting the infection than males above 6 to < 15 years. However, not all cases were subjected to TST and chest radiography. The primary reason for not investigating child contact for TB was their reported healthy or asymptomatic status. Conclusion The implementation of regular screening intervals for tuberculin skin test (TST) and chest radiography, along with verbal screening, among pediatric household contacts under the age of 15 years seems to be beneficial for the National TB Elimination Programme (NTEP), despite the challenges faced during implementation. Innovative strategies should be explored by NTEP to ensure effective implementation.

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TST positivity in household contacts of tuberculosis patients: a case-contact study in Malawi

Cited by 10 publications

References 24 publications

The Implementation of Early Detection in Tuberculosis Contact Investigation to Improve Case Finding

The Implementation of Early Detection in Tuberculosis Contact Investigation to Improve Case Finding

Determinants of losses in the latent tuberculosis cascade of care in Brazil: A retrospective cohort study

Tuberculosis screening for pediatric household contacts in India: Time to adapt newer strategies under the National TB Elimination Programme!

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