Integrated Source Case Investigation for Tuberculosis (TB) and HIV in the Caregivers and Household Contacts of Hospitalised Young Children Diagnosed with TB in South Africa: An Observational Study

Lala, Sanjay G.; Little, Kristen; Tshabangu, Nkeko; Moore, David P.; Msandiwa, Reginah; Watt, Martin van der; Chaisson, Richard E.; Martinson, Neil

doi:10.1371/journal.pone.0137518

Cited by 17 publications

(13 citation statements)

References 19 publications

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“…As the majority of child TB is not bacteriologically confirmed, we garner important information by comparing NNS using all forms of TB as our outcome and demonstrate that the NNS was 40% greater for a child index case compared to an adult index case. Previously reported source case investigations including children hospitalized for TB in TB/HIV high burden settings have demonstrated 2–3% yield [22, 23]. Similarly, the yield of source case investigation originating from index cases under five years of age participating in our program was 2.5%.…”

Section: Discussionsupporting

confidence: 50%

“…Although previous studies have demonstrated this potential [22], studies have also demonstrated significant challenges linking new cases to prompt treatment [29] and consistently low uptake of preventive TB treatment [30–35]. Similarly, only 25% of eligible contacts evaluated by our program initiated IPT.…”

Section: Discussionmentioning

confidence: 91%

“…As we were unable to measure our programs coverage rate of index cases, we cannot estimate the full potential of contact tracing in our setting if coverage rate was to increase. Similar to many other contact tracing studies [22, 23, 30], we were unable to follow contacts longitudinally and measure the impact of our intervention on TB prevention.…”

Section: Discussionmentioning

confidence: 99%

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BUTIMBA: Intensifying the Hunt for Child TB in Swaziland through Household Contact Tracing

et al. 2017

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BackgroundLimited data exists to inform contact tracing guidelines in children and HIV-affected populations. We evaluated the yield and additionality of household contact and source case investigations in Swaziland, a TB/HIV high-burden setting, while prioritizing identification of childhood TB.MethodsIn partnership with 7 local TB clinics, we implemented standardized contact tracing of index cases (IC) receiving TB treatment. Prioritizing child contacts and HIV-affected households, screening officers screened contacts for TB symptoms and to identify risk factors associated with TB. We ascertained factors moderating the yield of contact tracing and measured the impact of our program by additional notifications.ResultsFrom March 2013 to November 2015, 3,258 ICs (54% bacteriologically confirmed; 70% HIV-infected; 85% adults) were enrolled leading to evaluation of 12,175 contacts (median age 18 years, IQR 24–42; 45% children; 9% HIV-infected). Among contacts, 196 TB cases (56% bacteriologically confirmed) were diagnosed resulting in a program yield of 1.6% for all forms of TB. The number needed to screen (NNS) to identify a bacteriologically confirmed TB case or all forms TB case traced from a child IC <5 years was respectively 62% and 40% greater than the NNS for tracing from an adult IC. In year one, we demonstrated a 32% increase in detection of bacteriologically confirmed child TB. Contacts were more likely to have TB if <5 years (OR = 2.0), HIV-infected (OR = 4.9), reporting ≥1 TB symptoms (OR = 7.7), and sharing a bed (OR = 1.7) or home (OR = 1.4) with the IC. There was a 1.4 fold increased chance of detecting a TB case in households known to be HIV-affected.ConclusionContact tracing prioritizing children is not only feasible in a TB/HIV high-burden setting but contributes to overall case detection. Our findings support WHO guidelines prioritizing contact tracing among children and HIV-infected populations while highlighting potential to integrate TB and HIV case finding.

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Section: Discussionsupporting

confidence: 50%

Section: Discussionmentioning

confidence: 91%

Section: Discussionmentioning

confidence: 99%

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BUTIMBA: Intensifying the Hunt for Child TB in Swaziland through Household Contact Tracing

et al. 2017

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“…We also observed limited contact tracing, which is of added concern because data from Soweto, Johannesburg, have shown high rates of undiagnosed TB and HIV in the household contacts and caregivers of children with TB. [29]…”

Section: Researchmentioning

confidence: 99%

The costs and outcomes of paediatric tuberculosis treatment at primary healthcare clinics in Johannesburg, South Africa

et al. 2018

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“…A similar study by [77] in a study by [76] out of 267 index TB cases screened, 27 (10%) were HIV cases which is consistent with the finding of 4.3%. Further study by [73] generated 63% of HIV cases, though greater than study findings of 4.3% but authenticates the influence of HIV on TB transmission. This implies that integrating TB/HIV strategy during contact tracing of index is strongly recommended.…”

Section: Discussionmentioning

confidence: 54%

Effectiveness of Contact Tracing of Index Tuberculosis Cases in Nigeria

Onuka¹,

Okezie²,

Agboola³

et al. 2018

AID

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Tuberculosis (TB) is a chronic disease that has impacted negatively on human history. The biology of the mycobacterium tuberculosis is complicated and has affected the control as well as elimination of the disease. Nigeria is one of the countries with high incidence and prevalence of TB. The late and low case detection has been a major problem with National TB control program, caused by passive case finding strategy practiced by the country. A shift from the passive and active case search has been recommended for detection of missing cases of TB and improved program performance. The proximity of TB contact is a major determinant of disease transmission. However, maximizing early case detection and prompt treatment of notified cases is very useful in (TB) control especially in high burden countries. The tracking of TB contacts provides a good platform for early diagnosis, educating the household on TB disease and infection control as well as breaking the chain of transmission. The objective of the study is to ascertain effectiveness of contact tracing on Tuberculosis case detection. The study is a retrospective quasi experimental with quantitative arm. The study was conducted in Abia State, one of the South Eastern States of Nigeria. A pre-tested questionnaire was used for data collection and analyzed with SPSS. A total of 168 and 162 index cases of TB were recruited for both intervention and control facilities.

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Integrated Source Case Investigation for Tuberculosis (TB) and HIV in the Caregivers and Household Contacts of Hospitalised Young Children Diagnosed with TB in South Africa: An Observational Study

Cited by 17 publications

References 19 publications

BUTIMBA: Intensifying the Hunt for Child TB in Swaziland through Household Contact Tracing

BUTIMBA: Intensifying the Hunt for Child TB in Swaziland through Household Contact Tracing

The costs and outcomes of paediatric tuberculosis treatment at primary healthcare clinics in Johannesburg, South Africa

Effectiveness of Contact Tracing of Index Tuberculosis Cases in Nigeria

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