Investigation of household contacts of pulmonary tuberculosis patients increases case detection in Mwanza City, Tanzania

Abstract

BackgroundTuberculosis (TB) contact tracing is a key strategy for containing TB and provides addition to the passive case finding approach. However, this practice has not been implemented in Tanzania, where there is unacceptably high treatment gap of 62.1% between cases estimated and cases detected. Therefore calls for more aggressive case finding for TB to close this gap. We aimed to determine the magnitude and predictors of bacteriologically-confirmed pulmonary TB among household contacts of bacteriologically-confirmed pulmonary TB index cases in the city of Mwanza, Tanzania.MethodsThis study was carried out from August to December 2016 in Mwanza city at the TB outpatient clinics of Tertiary Hospital of the Bugando Medical Centre, Sekou-Toure Regional Hospital, and Nyamagana District Hospital. Bacteriologically-confirmed TB index cases diagnosed between May and July 2016 were identified from the laboratory registers book. Contacts were traced by home visits by study TB nurses, and data were collected using a standardized TB screening questionnaire. To detect the bacterioriologically-confirmed pulmonary TB, two sputum samples per household contact were collected under supervision for all household contacts following standard operating procedures. Samples were transported to the Bugando Medical Centre TB laboratory for investigation for TB using fluorescent smear microscopy, GeneXpert MTB/RIF and Löwenstein–Jensen (LJ) culture. Logistic regression was used to determine predictors of bacteriologically-confirmed pulmonary TB among household contacts.ResultsDuring the study period, 456 household contacts from 93 TB index cases were identified. Among these 456 household contacts, 13 (2.9%) were GeneXpert MTB/RIF positive, 18 (3.9%) were MTB-culture positive and four (0.9%) were AFB-smear positive. Overall, 29 (6.4%) of contacts had bacteriologically-confirmed pulmonary TB. Predictors of bacteriologically-confirmed pulmonary TB among household contacts were7being married (Odds ratio [OR], 3.3; 95% confidence interval [CI], 1.4–8.0; p = 0.012) and consuming less than three meals a day (OR, 3.7; 95% CI, 1.6–8.7; p = 0.009).ConclusionsOur data suggest that in Mwanza, Tanzania, seven in 100 contacts living in the same house with a TB patient develop bacteriologically-confirmed pulmonary TB. These results therefore underscore the need to implement routine TB contact tracing to control tuberculosis in high TB burden countries such as Tanzania.

Prevalence and Associated Factors of Tuberculosis among Adult Household Contacts of Smear Positive Pulmonary Tuberculosis Patients Treated in Public Health Facilities of Haramaya District, Oromia Region, Eastern Ethiopia

“…e finding is comparable with the other studies in sub-Saharan Africa (7.8%) [18], Peshawar (0.1-14%) [19], and Tanzania (6.4%) [20], but, higher than that reported from Nepal (1.6%) [21], India (1.15%) [7], Pondicherry of India (4.3%) [22], South Africa (3.9%) [23], and Ethiopia (1%) [24]. e variation might be related to differences in the study population, living situation, and overcrowding which are important risks for respiratory diseases, including tuberculosis [25].…”

“…is study revealed that the likelihood of TB among household contacts eating meals less than three times per day was 4 times higher than that of individuals who eat meals three times or more per day. is is in line with the studies conducted in Tanzania [20] and Pakistan [29]. is might be due to undernutrition or nutritional deficiency that impairs cell-mediated immunity which can lead to progression of latent infection to active TB disease.…”

Redesigning the Roles of Tuberculosis Treatment Supporter in Indonesia

“…Furthermore, TB treatment supporter characteristics were presented in Table 3. Another study revealed that 7 out of 100 contacts living in the same house with a TB patient developed bacteriologically-confirmed pulmonary TB (Beyanga et al, 2018). This study denoted that household contact with TB patients tended to get contagion of TB transmission without universal protection and functional knowledge.…”

Effectiveness of Contact Tracing of Index Tuberculosis Cases in Nigeria

“…Therefore, changing the passive case finding methodology to dynamic case detection strategy is crucial to improving TB case detection in Nigeria [24]. The contacts of infectious TB cases are predictors of TB transmission [58]. Tracking of contacts of TB cases in the community might be a complementary approach in detecting missing cases of TB [59].…”

“…Close proximity to infectious TB disease is key in TB transmission and infection [58]. Related published studies on contact tracing underpin the fact that contact tracking is an active method of detecting supplementary cases.…”