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Contacts of underserved tuberculosis patients have higher odds of TB disease in North West England: a cohort study

Wingfield, Tom ORCID: https://orcid.org/0000-0001-8433-6887, MacPherson, Peter ORCID: https://orcid.org/0000-0002-0329-9613, Sodha, P, Tucker, A, Mithoo, J, Squire, Bertie ORCID: https://orcid.org/0000-0001-7173-9038 and Cleary, P (2019) 'Contacts of underserved tuberculosis patients have higher odds of TB disease in North West England: a cohort study'. International Journal of Tuberculosis and Lung Disease, Vol 23, Issue 3, pp. 337-343.

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Abstract

OBJECTIVE
To investigate the association between patients' social risk factors and the risk of tuberculous infection and TB disease among their contacts in England.
DESIGN
This was a cohort study of all TB cases from North West England diagnosed between 27 March 2012 and 28 June 2016. The social risk factors of TB cases were evaluated to estimate their need for enhanced case management (ECM), from 0 (standard of care) to 3 (intensive social support).
RESULTS
A total of 2139 cases and their 10 019 contacts met the eligibility criteria. Being a contact of a patient with smear-positive TB with high ECM or being of Black Caribbean ethnicity was independently associated with greater odds of active TB disease (smear-positive vs. smear-negative, OR 5.3, 95%CI 3.2-8.7; ECM-3 vs. ECM-0, OR 2.2, 95%CI 1.01-5.0; Black Caribbean vs. White, OR 7.4, 95%CI 2.1-25). Being a contact of a patient with smear-positive TB or of Black Caribbean ethnicity was also independently associated with greater odds of tuberculous infection (smear-positive vs. smear-negative, OR 5.3, 95%CI 3.8-7.3; and Black Caribbean vs. White, OR 6.7, 95%CI 2.0-25).
CONCLUSIONS
The social complexity and ethnicity of patients were associated with tuberculous infection and TB disease in their contacts.

Item Type: Article
Subjects: WF Respiratory System > WF 100 General works
WF Respiratory System > Tuberculosis > WF 200 Tuberculosis (General)
WF Respiratory System > Tuberculosis > WF 205 Epidemiology
Faculty: Department: Clinical Sciences & International Health > Clinical Sciences Department
Digital Object Identifer (DOI): https://doi.org/10.5588/ijtld.18.0467
Depositing User: Stacy Murtagh
Date Deposited: 19 Mar 2019 16:17
Last Modified: 13 Nov 2019 11:23
URI: https://archive.lstmed.ac.uk/id/eprint/10432

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