Prevalence and risk factors for latent tuberculosis infection among household contacts of index cases in two South African provinces: Analysis of baseline data from a cluster-randomised trial

MacPherson, Peter; Lebina, Limakatso; Motsomi, Kegaugetswe; Bosch, Zama; Milovanovic, Minja; Ratsela, Andrew; Lala, Sanjay G.; Variava, Ebrahim; Golub, Jonathan E.; Webb, Emily L.; Martinson, Neil

doi:10.1371/journal.pone.0230376

Cited by 26 publications

(20 citation statements)

References 25 publications

(24 reference statements)

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“…We found that, in the intervention arm, prevalence of latent TB (defined by TST) was 13%, comparable to previous household contact tracing studies from the region [26], and with strong age- and site-specific dependency [28]. At 15-months, TST positivity in children was higher in the intervention arm than the SOC arm.…”

Section: Discussionsupporting

confidence: 84%

Household contact tracing with intensified tuberculosis and HIV screening in South Africa: a cluster randomised trial

Martinson

Lebina

Webb

et al. 2021

Preprint

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Background Household contact tracing for tuberculosis (TB) may facilitate TB diagnosis and identify individuals who may benefit from TB preventive therapy (TPT). In this cluster-randomised trial, we investigated whether household contact tracing and intensive TB/HIV screening would improve TB-free survival. Methods Household contacts of index TB patients in two Provinces of South Africa were randomised to home tracing and intensive HIV/TB screening (sputum Xpert and culture; HIV testing with treatment linkage; and TPT, if eligible), or standard of care (SOC, clinic referral letters). The primary outcome was incident TB or death at 15-months. Secondary outcomes included tuberculin skin test (TST) positivity in children ≤14 years and undiagnosed HIV. (ISRCTN16006202). Results From December 2016-March 2019, 1,032 index patients (4,459 contacts) and 1,030 (4,129 contacts) were randomised to the intervention and SOC arms. 3.2% (69/2166) of intervention arm contacts had prevalent microbiologically-confirmed TB. At 15-months, the cumulative incidence of TB or death did not differ between the intensive screening (93/3230, 2.9%) and SOC (80/2600, 3.1%) arms (hazard ratio: 0.90, 95% confidence interval (CI): 0.66-1.24). TST positivity was higher in the intensive screening arm (38/845, 4.5%) compared to the SOC arm (15/800, 1.9%, odds ratio: 2.25, 95% CI: 1.07-4.72). Undiagnosed HIV was similar between arms (41/3185, 1.3% vs. 32/2543, 1.3%; odds ratio: 1.02, 95% CI: 0.64-1.64). Conclusions Household contact tracing with intensive screening and referral did not reduce incident TB or death. Providing referral letters to household contacts of index patients is an alternative strategy to home visits in high TB/HIV-prevalence settings.

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Section: Discussionsupporting

confidence: 84%

Household contact tracing with intensified tuberculosis and HIV screening in South Africa: a cluster randomised trial

Martinson

Lebina

Webb

et al. 2021

Preprint

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“…Although DM was not associated with LTBI in our study, DM patients are considered as a high-risk group under the national programme; all diabetics are subjected to active TB screening at a primary care level, during their noncommunicable disease clinic visits [32,33]. Similarly, malnutrition and TB have a bidirectional relationship and higher BMI increases the risk of diabetes, which in turn increases the chances of LTBI [34][35][36][37].…”

Section: Discussionmentioning

confidence: 60%

Prevalence and risk factors associated with latent tuberculosis infection among household contacts of smear positive pulmonary tuberculosis patients in South India

Krishnamoorthy

Ezhumalai

Murali

et al. 2021

Tropical Med Int Health

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“…7 A person infected with M. tuberculosis has a 10% risk of developing TB disease during their lifetime, but for people co-infected with both M. tuberculosis and HIV, the annual risk of developing active TB disease exceeds 10%. 8 The complication of treatment outcomes of both diseases due to the TB/HIV co-infection results particularly from the concomitant use of anti-retroviral treatment (ART) and the intensive phase of TB treatment; in addition, it leads to drug-drug interactions, side effects of multiple drugs, increased pill burden, decreased adherence, and the development of higher rates of drug-resistant organisms because of the combination of these factors. 9 Ethiopia is one of the developing countries with a high burden of TB/HIV co-infections.…”

Section: Introductionmentioning

confidence: 99%

Tuberculosis and Human Immunodeficiency Virus Co-Infection and Associated Factors at Debre Markos Comprehensive Specialized Hospital, Northwest Ethiopia: A Four-Year Retrospective Study

Alemu

Aycheh

Dilnessa

2021

HIV

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Background: Human immunodeficiency virus (HIV) and tuberculosis (TB) are the principal global causes of death among patients with communicable diseases. Because of shared immune defense mechanisms, they are the primary cause of morbidity worldwide. However, little information was found regarding the magnitude of TB/HIV co-infection in the study area, in Northwest Ethiopia. Objective: The main aim of this study was to assess the prevalence of TB and HIV coinfection and associated factors among TB patients. Methods: All TB patients at Debre Markos Comprehensive Specialized Hospital were included from September 11, 2012 to September 10, 2016. Data were analyzed using SPSS version 22. Logistic regression was used to determine the associations between independent and outcome variables. Results: A total of 180 TB patients were enrolled. Pulmonary tuberculosis (PTB) accounted for 97/180 (53.9%), followed by extrapulmonary tuberculosis (EPTB) in 83/180 (46.1%). There were 164/180 (91.1%) new TB cases and 16/180 (8.9%) treatment failures, but no relapsing or defaulting cases were observed. Forty percent (72/180) of patients were coinfected with TB and HIV. The likelihoods of having TB/HIV co-infection were 3.2 and 2.1 times higher in PTB smear-positive and PTB smear-negative patients (AOR=3.2, 95% CI 1.4-8.1, p=0.006; and AOR=2.1, 95% CI 1.0-4.3, respectively, p=0.05), in comparison to EPTB. The rate of TB/HIV co-infection was 28/66 (42.4%) in 2013, 18/38 (47.4%) in 2014, 13/32 (40.6%) in 2015, and 13/44 (29.5%) in 2016. Conclusion: TB/HIV co-infection showed a decreasing trend in the past 2 years in the study area. TB/HIV co-infection is one of the most serious community health concerns in the study area. Therefore, TB/HIV collaborative activities should be implemented to reduce coinfection and its impact on the community.

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Prevalence and risk factors for latent tuberculosis infection among household contacts of index cases in two South African provinces: Analysis of baseline data from a cluster-randomised trial

Abstract: Prevalence and risk factors for latent tuberculosis infection among household contacts of index cases in two South African provinces: Analysis of baseline data from a cluster-randomised trial. PLoS ONE 15(3): e0230376.

Cited by 26 publications

References 25 publications

Household contact tracing with intensified tuberculosis and HIV screening in South Africa: a cluster randomised trial

Household contact tracing with intensified tuberculosis and HIV screening in South Africa: a cluster randomised trial

Prevalence and risk factors associated with latent tuberculosis infection among household contacts of smear positive pulmonary tuberculosis patients in South India

Tuberculosis and Human Immunodeficiency Virus Co-Infection and Associated Factors at Debre Markos Comprehensive Specialized Hospital, Northwest Ethiopia: A Four-Year Retrospective Study

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