A population-based tuberculosis contact investigation in the country of Georgia

Baliashvili, Davit; Kempker, Russell R.; Blumberg, Henry M.; Kuchukhidze, Giorgi; Merabishvili, Tsira; Aslanikashvili, Ana; Magee, Matthew J.

doi:10.5588/pha.18.0024

Cited by 8 publications

(6 citation statements)

References 26 publications

(24 reference statements)

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“…We reported a high prevalence of LTBI among HHCs, with the QFT-GIT results of over half our participants indicating positivity for LTBI. For HHCs with complete data (174), the prevalence of LTBI was 55.7%, which was higher than the global average of 23% [ 10 ], and 34% in Georgia and 12.7% in Singapore [ 11 , 12 ]. However, similar results have been reported in Ethiopia, where the prevalence of LTBI is observed as 63.7% [ 13 ].…”

Section: Discussionmentioning

confidence: 99%

Latent tuberculosis among household contacts of pulmonary tuberculosis cases in Nairobi, Kenya

Odera¹,

Mureithi²,

Aballa³

et al. 2020

Pan Afr Med J

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Introduction Household Contacts (HHCs) of Pulmonary Tuberculosis (PTB) patients have a higher risk of latent tuberculosis infection (LTBI). However, its prevalence and risk factors among adults living with PTB patients are poorly documented in Kenya. Objective to determine the prevalence and risk factors for LTBI among adult HHCs of PTB patients in Kenya. Methods this was an analytical cross-sectional study of HHCs of PTB patients in Nairobi, Kenya. Socio-demographic data was captured on questionnaires and blood samples drawn for Interferon gamma (IFN-γ) quantification. Univariate and multivariate analyses using the Statistical Package for Social Scientists (SPSS) was used to determine the prevalence of LTBI and risk factors at 95% Confidence Interval (CI). Results a total of 166 PTB patients yielded 175 HHCs of whom 29.7% (52/125) were males and 70.3% (123/125) were females. A majority of HHCs [65.7% (115/175)] lived in a single-room house with the patient and [37.7% (66/175)] were in the age group 30-39-years. The overall prevalence of LTBI was 55.7%, peaking among spouses of the patients [70.0% (14/20) and the 30-39 year age group [63.5% (42/66)]. Potential risk factors for LTBI included cohabiting with a PTB patient for 8 to 12 weeks [OR = 3.6 (0.70-18.5), p = 0.107], being a spouse of the patient [OR = 2.0 (0.72-5.47), p = 0.173] and sharing a single room with the patient [OR = 1.58 (0.84 - 2.97), p = 0.158]. Conclusion the high prevalence of LTBI among adult HHCs of PTB patients in this population demonstrates the need for targeted contact-screening programs in high TB transmission settings.

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Section: Discussionmentioning

confidence: 99%

Latent tuberculosis among household contacts of pulmonary tuberculosis cases in Nairobi, Kenya

Odera¹,

Mureithi²,

Aballa³

et al. 2020

Pan Afr Med J

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“…At-risk patients were often highly mobile, and families could be difficulty to contact or locate. 29 46 49 51 73–75 Additional patient/family-related factors that have been statistically associated with lack of testing included both older age 50 70 and younger age, 72 and presence of comorbidities. 66 75 …”

Section: Resultsmentioning

confidence: 99%

“…► Medical contraindications (concurrent infectious disease and chronic disease).66 75 ► Low perceived risk 49. ► Older age50 .► Patient mobility/inability to contact at-risk patients 29. 49 74 75 ► Test stock-outs.…”

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confidence: 99%

A scoping review of paediatric latent tuberculosis infection care cascades: initial steps are lacking

2021

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Background and objectivesIdentifying and treating children with latent tuberculosis infection (TB infection) is critical to prevent progression to TB disease and to eliminate TB globally. Diagnosis and treatment of TB infection requires completion of a sequence of steps, collectively termed the TB infection care cascade. There has been no systematic attempt to comprehensively summarise literature on the paediatric TB infection care cascade.MethodsWe performed a scoping review of the paediatric TB infection care cascade. We systematically searched PubMed, Cumulative Index to Nursing and Allied Health Literature, Cochrane and Embase databases. We reviewed articles and meeting abstracts that included children and adolescents ≤21 years old who were screened for or diagnosed with TB infection, and which described completion of at least one step of the cascade. We synthesised studies to identify facilitators and barriers to retention, interventions to mitigate attrition and knowledge gaps.ResultsWe identified 146 studies examining steps in the paediatric TB infection care cascade; 31 included children living in low-income and middle-income countries. Most literature described the final cascade step (treatment initiation to completion). Studies identified an array of patient and caregiver-related factors associated with completion of cascade steps. Few health systems factors were evaluated as potential predictors of completion, and few interventions to improve retention were specifically tested.ConclusionsWe identified strengths and gaps in the literature describing the paediatric TB infection care cascade. Future research should examine cascade steps upstream of treatment initiation and focus on identification and testing of at-risk paediatric patients. Additionally, future studies should focus on modifiable health systems factors associated with attrition and may benefit from use of behavioural theory and implementation science methods to improve retention.

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“…The prolonged exposure predisposes HHCs to a higher risk of infection, morbidity, and mortality. The WHO recommends routine contact tracing and investigation in PTB high burden countries through counseling and education of HHCs, who are the primary caregivers for active PTB patients at home [3,4]. However, implementation of these recommendations in low-resource settings is poor hence screening of HHCs has remained sub-optimal.…”

Section: Discussionmentioning

confidence: 99%

Challenges Faced by House-Hold Contacts of Pulmonary Tuberculosis Patients In An Urban Setting In Nairobi, Kenya

Odera¹,

Oyugi²,

Angeline³

et al. 2021

J Infect Dis Case Rep

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Close contacts of active pulmonary tuberculosis (PTB) patients are at higher risk of infection as the confirmed cases remain highly infectious before and while in the early stages of treatment. This work highlights the encounters and perspectives of household contacts (HHCs) of PTB patients in an urban setting in Kenya, with a focus on accessibility to health services, interactions within the community, and the risk of infection at home. A multimethod study design involving descriptive cross-sectional analysis and informal interviews was used. The study participants were recruited from tuberculosis (TB) isolation wards and outpatient clinics of Mbagathi County Hospital in Nairobi, Kenya. Data was collected using structured questionnaires and informal interviews. Results revealed improved access to treatment by PTB patients. However, the global goal of eliminating TB infections by minimizing latent tuberculosis reactivation remains a challenge in this population primarily because most of the HHCs lacked knowledge on diagnosis and treatment of latent tuberculosis infection (LTBI). Most participants were residents of informal settlements in Nairobi characterized by small and poorly planned housing structures with poor waste management systems. In most houses, the living space doubled as cooking and sleeping area. There was therefore a high exposure of spouses, children and other persons living with the patients. We recommend that further education be provided to HHCs to increase awareness on available testing and preventive treatment for LTBI, and infection prevention practices at the household level. Furthermore, additional resources should be offered to economically disadvantaged patients to support their social and treatment needs.

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A population-based tuberculosis contact investigation in the country of Georgia

Cited by 8 publications

References 26 publications

Latent tuberculosis among household contacts of pulmonary tuberculosis cases in Nairobi, Kenya

Latent tuberculosis among household contacts of pulmonary tuberculosis cases in Nairobi, Kenya

A scoping review of paediatric latent tuberculosis infection care cascades: initial steps are lacking

Challenges Faced by House-Hold Contacts of Pulmonary Tuberculosis Patients In An Urban Setting In Nairobi, Kenya

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