Is 1-year follow-up adequate for adult tuberculosis contacts?

Feng, Jia; Chen, San‐Chi; Lee, Ming-Che; Fan, Wei; Su, Wei; Hu, Yu-Wen; Yeh, Chiu Mei; Chen, Tzeng Ji; Liu, Chia Jen

doi:10.1183/09031936.00142114

Cited by 6 publications

(5 citation statements)

References 13 publications

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“…A Canadian study that followed up contacts in congregate settings and household contacts for an average of 6 years reported that 86% contacts who developed active TB were diagnosed within 2 years, similar to our findings 16 . Although differing in terms of the follow-up duration and participants, recent studies, including the present one 13,14,[16][17][18] , have reported that the 2-year incidence of TB in contacts was 63%-94.9%, which is higher than that reported in earlier studies 5,19 . According to the ROK guidelines on follow-up of contacts, follow-up chest radiography was conducted at 3 months and 9 months after exposure in contacts who were negative for LTBI.…”

Section: Discussioncontrasting

confidence: 55%

Risk of active tuberculosis development in contacts exposed to infectious tuberculosis in congregate settings in Korea

Park

Han

Kim

et al. 2020

Sci Rep

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Contact investigation is an important and effective active case-finding strategy, but there is a lack of research on congregate settings in countries with an intermediate incidence. this study determined the incidence of and risk factors for tuberculosis (tB) development after exposure in congregate settings. This retrospective cohort study included 116,742 contacts identified during the investigation of 2,609 TB cases diagnosed from January to December 2015. We searched the Korean National Tuberculosis Surveillance System tB registry to identify contacts that developed active tB during follow-up until May 2018. During the mean observation period of 2.9 years, 499 of 116,742 contacts (0.4%) developed new active TB. From these contacts, 404 (81.0%) developed TB within 2 years after exposure. The 2-year Kaplan-Meier cumulative risk for tB was the highest in contacts aged ≥65 years [1%; 95% confidence interval (CI), 0.8-1.3]. Contacts with LTBI who completed chemoprophylaxis exhibited a lower risk of active TB development than those without chemoprophylaxis (adjusted hazard ratio, 0.16; 95% CI, 0.08-0.29). Aggressive contact investigation is effective for the early detection and prevention of TB in congregate settings. the risk of progression to active tB among contacts with LtBi can be minimised by the completion of chemoprophylaxis. Tuberculosis (TB) imposes a high global disease burden, with more than 10 million new patients and 1.6 million annual deaths worldwide 1. The global burden of latent TB infection (LTBI) was 23.0%, amounting to approximately 1.7 billion people. WHO SouthEast Asia, Western-Pacific, and Africa regions had the highest prevalence and accounted for approximately 80% of those with LTBI 1,2. Although the incidence of TB in the Republic of Korea (ROK) has decreased from 89 per 100,000 in 2013 to 70 per 100,000 in 2017, it remains greater than that in any other country within the Organization for Economic Cooperation and Development nations 1,3. Generally, 5-10% individuals with LTBI develop active TB in their lifetime, with 50% developing active disease within 2 years after infection 4-6. Thus, the management of recent contacts of patients with infectious TB is important for the overall management of TB. The World Health Organization (WHO) recommends that tests and treatments for LTBI should be prioritised for contacts of TB patients 7. The Korea Centers for Disease Control and Prevention (KCDC) established a TB epidemic investigation team in 2013. Between 2013 and 2017, there were 12,447 investigations with about 700,000 contacts 8. However, follow-up research addressing TB incidence among contacts residing in areas with intermediate-level TB incidence is lacking, and most studies have addressed household contacts, with a lack of discussion regarding the TB incidence and relevant risk factors among contacts in congregate settings 9-11. The present study aimed to analyse the TB incidence in individuals who had contact with TB cases in congregate settings and evaluate the risk factors that influ...

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Section: Discussioncontrasting

confidence: 55%

Risk of active tuberculosis development in contacts exposed to infectious tuberculosis in congregate settings in Korea

Park

Han

Kim

et al. 2020

Sci Rep

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“…Furthermore, diagnosis of TB contacts by ICD-9-CM has been widely used in epidemiologic studies. 18 , 19 However, we did not validate LTBI cohort in this analysis. Patients with LTBI may be misclassified into comparison group and patients without LTBI may be misclassified into LTBI cohort and resulted in a misclassification bias.…”

Section: Discussionmentioning

confidence: 95%

Latent Tuberculosis Infection and the Risk of Subsequent Cancer

Yen

Pan

et al. 2016

Medicine

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“…People exposed to TB cases have a higher risk of acquiring TB infection than the general population. 8 They may have active TB or only latent TB infection (LTBI). 9 Importantly, a person with LTBI still has a 5% to 10% lifetime risk of developing active TB disease, and half of this risk occurs in the first 2 years after exposure.…”

Section: Introductionmentioning

confidence: 99%

The Risk of Depressive Disorder Among Contacts of Tuberculosis Patients in a TB-endemic Area

et al. 2015

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Tuberculosis (TB) disease may be transmitted to close contacts of index cases, causing physical illness. No studies have investigated the risk of developing depressive disorder among TB contacts in a TB-endemic area.Adult participants with a new diagnosis of TB contact (ICD-9-CM codes V01.1 plus chest radiographic order) since January 1, 2008, were identified from the National Health Insurance Research Database in Taiwan. A control cohort matched for age (±5 y), sex, enrolled years, and income level was selected. These 2 cohorts were followed until December 31, 2012, and observed for the development of depressive disorder. The Kaplan-Meier method and the log-rank test were used to examine the difference in cumulative incidences of depressive disorder between groups. Cox proportional-hazard models were used to calculate adjusted hazard ratios (aHRs) for depressive disorder.The TB contact cohort consisted of 9046 patients and matched controls of 36,184 ones. The mean age of TB contacts was 44.7 years, and 56.0% of them were women. During a mean follow-up period of 2.5 years, 127 (1.40%) TB contacts and 521 (1.44%) matched controls developed depressive disorder. TB exposure was found to be an independent risk factor of depressive disorder in women (aHR 1.34, 95% confidence interval [CI] 1.07–1.68), but not in men (aHR 0.71, 95% CI 0.48–1.06) after adjusting for age, comorbidities, and income levels. The risk of depression was significantly higher for female TB contacts than for matched controls in the first and second years (aHR 1.49, 95% CI 1.03–2.14; and aHR 1.53, 95% CI 1.05–2.23, respectively), but not thereafter. Of note, 67 (0.74%) TB contacts and 88 (0.24%) matched controls developed active TB, but none of them had subsequent depressive disorder during follow-up periods.Female TB contacts had an increased risk of depression within the first 2 years after exposure. Clinicians should consider conducting depression evaluations in addition to routine TB contact investigations in this subgroup population.

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Is 1-year follow-up adequate for adult tuberculosis contacts?

Cited by 6 publications

References 13 publications

Risk of active tuberculosis development in contacts exposed to infectious tuberculosis in congregate settings in Korea

Risk of active tuberculosis development in contacts exposed to infectious tuberculosis in congregate settings in Korea

Latent Tuberculosis Infection and the Risk of Subsequent Cancer

The Risk of Depressive Disorder Among Contacts of Tuberculosis Patients in a TB-endemic Area

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