The Prevalence Rate of Tuberculin Skin Test Positive by Contacts Group to Predict the Development of Active Tuberculosis After School Outbreaks

Kim, Hee Jin; Chun, Byung Chul; Kwon, Amy M.; Lee, Gyeong Ho; Ryu, Sungweon; Oh, Soo Yeon; Lee, Jin Beom; Yoo, Se Hwa; Kim, Eui Sook; Kim, Je Hyeong; Shin, Cheolmin; Lee, Seung Heon

doi:10.4046/trd.2015.78.4.349

Cited by 6 publications

(5 citation statements)

References 18 publications

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“…Contact investigation is considered a means to improve early case detection and decrease the transmission of M tuberculosis (Mtb) in high-incidence areas [3]. Adolescent active TB case detection rates in school outbreak settings have been reported to be 2.9% in Korea [4], 4.1% in China [5], and 6% in the United Kingdom [6], suggesting TB is actively transmitted in school [5,7,8], particularly in students who share classes with the index case patient [9]. However, in most school TB outbreak investigations, contact investigation is usually confined to the school, while household transmission is often overlooked and neglected [10,11], and where potential household contacts with active disease may be identified.…”

Section: Introductionmentioning

confidence: 99%

Tuberculosis Transmission in Households and Classrooms of Adolescent Cases Compared to the Community in China

Pan

Lin

Lan

et al. 2018

IJERPH

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The aim of this paper is to evaluate the link between the history of exposure to tuberculosis (TB) in the household and diagnosed TB cases at school, and to compare the detection rate of active TB among household contacts and classroom contacts of adolescent TB cases with the rates among contacts of healthy controls. From November 2016 to December 2017, a prospective matched case-control study was conducted using passively identified index adolescent student cases from the TB surveillance system and healthy controls (matched by county, school type, sex, age and ethnicity). Contacts in households and classrooms of index cases and of controls were investigated. Matched tabulation of 117 case-control pairs revealed exposure to TB in the household as a strong risk factor (odds ratio (OR) = 21.0, 95% confidence interval (CI): 3.4, 868.6). Forty-five (case detection rate 0.69%) and two (case detection rate 0.03%) new active TB cases were detected among 6512 and 6480 classroom contacts of the index cases and controls, respectively. Having an index case in the classroom significantly increased the risk of classmates contracting active TB (OR = 22.5, 95% CI: 5.9, 191.4). Our findings suggested that previous exposure to TB in the household could lead a child to catch TB at school, then spread TB to classmates.

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Section: Introductionmentioning

confidence: 99%

Tuberculosis Transmission in Households and Classrooms of Adolescent Cases Compared to the Community in China

Pan

Lin

Lan

et al. 2018

IJERPH

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“…The primary characteristics of the studies included in the review are summarized in Table 1. In total, 28 studies with 54,707 school contacts were included in the pooled prevalence of M. tuberculosis infection, of which 19 studies were from China, [13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31] three were from Italy, [32][33][34] two were from Korea, 35,36 and four studies each were from Iran, 37 Japan, 38 Sweden, 39 and the United States, 40 respectively. In regard to study design, 15 were cross-sectional studies and 11 were retrospective studies.…”

Section: Resultsmentioning

confidence: 99%

Mycobacterium tuberculosis Infection in School Contacts of Tuberculosis Cases: A Systematic Review and Meta-Analysis

Wang,

Liu,

Liu

et al. 2024

The American Journal of Tropical Medicine and Hygiene

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Substantial tuberculosis transmission occurs outside of households, and tuberculosis surveillance in schools has recently been proposed. However, the yield of tuberculosis outcomes from school contacts is not well characterized. We assessed the prevalence of Mycobacterium tuberculosis infection among close school contacts by performing a systematic review. We searched PubMed, Elsevier, China National Knowledge Infrastructure, and Wanfang databases. Studies reporting the number of children who were tested overall and who tested positive were included. Subgroup analyses were performed by study location, index case bacteriological status, type of school, and other relevant factors. In total, 28 studies including 54,707 school contacts screened for M. tuberculosis infection were eligible and included in the analysis. Overall, the prevalence of M. tuberculosis infection determined by the QuantiFERON Gold in-tube test was 33.2% (95% CI, 0.0–73.0%). The prevalences of M. tuberculosis infection based on the tuberculin skin test (TST) using 5 mm, 10 mm, and 15 mm as cutoffs were 27.2% (95% CI, 15.1–39.3%), 24.3% (95% CI, 15.3–33.4%), and 12.7% (95% CI, 6.3–19.0%), respectively. The pooled prevalence of M. tuberculosis infection (using a TST ≥5-mm cutoff) was lower in studies from China (22.8%; 95% CI, 16.8–28.8%) than other regions (36.7%; 95% CI, 18.1–55.2%). The pooled prevalence of M. tuberculosis infection was higher when the index was bacteriologically positive (43.6% [95% CI, 16.5–70.8%] versus 23.8% [95% CI, 16.2–31.4%]). These results suggest that contact investigation and general surveillance in schools from high-burden settings merit consideration as means to improve early case detection in children.

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“…The international experience coincides in the low incidence of secondary cases, [13][14][15][23][24][25] although incidences between 3% and 6% have also been reported. 16,[26][27][28][29] Boarding schools and schools where teachers were index cases showed higher values (17-42%). 22,30 The loss to follow-up is large if several points of contact are raised.…”

Section: The Incidence Of Tuberculin Conversion Among School Contacts...mentioning

confidence: 98%

Prevalence of latent tuberculosis infection and incidence of tuberculin conversion among school contacts older than 5 years in the City of Buenos Aires

et al. 2023

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Introduction.Tuberculosis continues to be a common problem in settings of socioeconomic vulnerability. Our primary objective was to establish the prevalence of latent infection and tuberculin conversion among school contacts of tuberculosis cases. Population and methods.In a programmatic area in the south of the City of Buenos Aires, the prevalence of latent infection and tuberculin conversion was assessed in 691 children and adolescents using the tuberculin skin test. The association between loss to follow-up by the health care team and the demographic, school, and baseline care characteristics was studied, and the level of adherence when isoniazid chemoprophylaxis was indicated was described.Results. According to established definitions, the prevalence of latent infection was between 3.4% (95% confidence interval [CI]: 2.3-5.2) and 11.6% (95% CI: 9.3-14.4) in the 610 contacts with at least one skin test. The incidence of tuberculin conversion was between 0.3% and 6.8% in the 294 assessed participants. Age older than 18 years, a higher prevalence of unmet basic needs in the school district, attending the afternoon school shift, negative sputum smear results in the index case, and absence of baseline skin test were associated with contact lost to follow-up.Conclusions. The incidence of tuberculin conversion among school contacts was low. Adherence to isoniazid treatment remains limited. Factors associated with loss of contact tracing were identified, which may guide strategies necessary to improve this process.

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The Prevalence Rate of Tuberculin Skin Test Positive by Contacts Group to Predict the Development of Active Tuberculosis After School Outbreaks

Cited by 6 publications

References 18 publications

Tuberculosis Transmission in Households and Classrooms of Adolescent Cases Compared to the Community in China

Tuberculosis Transmission in Households and Classrooms of Adolescent Cases Compared to the Community in China

Mycobacterium tuberculosis Infection in School Contacts of Tuberculosis Cases: A Systematic Review and Meta-Analysis

Prevalence of latent tuberculosis infection and incidence of tuberculin conversion among school contacts older than 5 years in the City of Buenos Aires

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