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Yield of Household Contact Investigation of Patients with Pulmonary Tuberculosis in Southern Ethiopia

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Yassin, Mubarek A, Yirdaw, Kesetebirhan D, Datiko, Daniel G, Cuevas, Luis ORCID: https://orcid.org/0000-0002-6581-0587 and Yassin, Mohammed A. (2020) 'Yield of Household Contact Investigation of Patients with Pulmonary Tuberculosis in Southern Ethiopia'. BMC Public Health, Vol 20, Issue 737.

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Abstract

Background: Household Contacts (HHCs) of patients with pulmonary tuberculosis (PTB) have a higher risk of developing TB. Contact investigation is recommended to reach this group and identify undiagnosed cases. In this study, we have determined the yield of contact investigation among HHCs of patients with smear-positive PTB, and estimated TB burden.
Methods: We conducted retrospective record review for the occurrence of TB among HHCs of Index PTB+ cases treated between November 2010 and April 2013 in 12 public health facilities in Boricha district. HHCs were followed up monthly and revisited between March and June 2015. Information on additional TB cases diagnosed and treated among HHCs were documented. HHCs who were diagnosed as having TB after the index cases were diagnosed and treated were considered as ‘incident cases’. Presumptive TB case was defined as those having cough for ≥2 weeks or enlarged lymph node. Diagnosis of TB among HHCs were made using smear-microscopy and/or X-rays, and clinically for Extra-pulmonary TB (EPTB).
Results: 1,517 HHCs of 344 index cases were visited and screened for TB and followed up for a median of 37 months. 77 (5.1% - 72 with PTB and 5 with EPTB) HHCs developed TB during 4,713 person-years of follow-up with an estimated incidence of 1,634 (95% CI: 1,370-2,043) per 100,000 person-years follow-up which is much higher than the estimated TB incidence for the general population in Ethiopia of 210/100,000. Half (41/77) of incident TB cases were diagnosed within the first year of diagnosis of the index cases and 88% (68/77) were adults (Hazard Ratio: 4.03; 95% CI: 2.00-8.12).
Conclusion: HHCs of index PTB+ cases have high risk of developing active TB. Long term follow-up of HHCs could help improve TB case finding depending on country contexts. Further studies on effectiveness and feasibility of the approach and integration in routine settings are needed.

Key words: Tuberculosis; Index case; Household Contacts; Contact Investigation; Case finding.

Item Type: Article
Subjects: WA Public Health > Preventive Medicine > WA 110 Prevention and control of communicable diseases. Transmission of infectious diseases
WA Public Health > Health Problems of Special Population Groups > WA 395 Health in developing countries
WF Respiratory System > Tuberculosis > WF 200 Tuberculosis (General)
Faculty: Department: Clinical Sciences & International Health > International Public Health Department
Digital Object Identifer (DOI): https://doi.org/10.1186/s12889-020-08879-z
Depositing User: Christine Bradbury
Date Deposited: 26 May 2020 13:49
Last Modified: 26 May 2020 13:49
URI: https://archive.lstmed.ac.uk/id/eprint/14540

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