Yield of contact tracing from pediatric tuberculosis index cases in Gaborone, Botswana

Puryear, Sarah; Seropola, Gorewang; Ho-Foster, Ari; Arscott-Mills, Tonya; Mazhani, Loeto; Firth, J. A.; Goldfarb, David M.; Ncube, Ronald; Bisson, Gregory P.; Steenhoff, Andrew P.

doi:10.5588/ijtld.12.0933

Cited by 23 publications

(27 citation statements)

References 9 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…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: Discussionmentioning

confidence: 50%

“…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%

See 1 more Smart Citation

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

et al. 2017

View full text Add to dashboard Cite

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.

show abstract

Section: Discussionmentioning

confidence: 50%

Section: Discussionmentioning

confidence: 99%

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

et al. 2017

View full text Add to dashboard Cite

show abstract

“…We found that child contacts younger than five years had the highest risk of being diagnosed with TB. Although some studies and systematic reviews have reported that the yield among children is comparable to that seen in adult contacts [5,25], some studies have shown that there is a high prevalence of TB in children among contacts, as seen in our study [26,27]. This can be explained by the fact that young children are more likely to stay at home, which can increase exposure time especially if the index cases are their first-degree relatives [28].…”

Section: Discussioncontrasting

confidence: 48%

Outcomes of Community-Based Systematic Screening of Household Contacts of Patients with Multidrug-Resistant Tuberculosis in Myanmar

Kyaw¹,

Aung²,

Satyanarayana

et al. 2019

TropicalMed

View full text Add to dashboard Cite

Screening of household contacts of patients with multidrug-resistant tuberculosis (MDR-TB) is a crucial active TB case-finding intervention. Before 2016, this intervention had not been implemented in Myanmar, a country with a high MDR-TB burden. In 2016, a community-based screening of household contacts of MDR-TB patients using a systematic TB-screening algorithm (symptom screening and chest radiography followed by sputum smear microscopy and Xpert-MTB/RIF assays) was implemented in 33 townships in Myanmar. We assessed the implementation of this intervention, how well the screening algorithm was followed, and the yield of active TB. Data collected between April 2016 and March 2017 were analyzed using logistic and log-binomial regression. Of 620 household contacts of 210 MDR-TB patients enrolled for screening, 620 (100%) underwent TB symptom screening and 505 (81%) underwent chest radiography. Of 240 (39%) symptomatic household contacts, 71 (30%) were not further screened according to the algorithm. Children aged <15 years were less likely to follow the algorithm. Twenty-four contacts were diagnosed with active TB, including two rifampicin- resistant cases (yield of active TB = 3.9%, 95% CI: 2.3%–6.5%). The highest yield was found among children aged <5 years (10.0%, 95% CI: 3.6%–24.7%). Household contact screening should be strengthened, continued, and scaled up for all MDR-TB patients in Myanmar.

show abstract

“…Here 31% of households had at least 1 additional previously undiagnosed person with either latent or active TB disease 13 .…”

Section: Discussionmentioning

confidence: 99%

Source case identification in HIV-exposed infants and tuberculosis diagnosis in an isoniazid prevention study

Maritz

Montepiedra

Liu

et al. 2016

int j tuberc lung dis

View full text Add to dashboard Cite

Background Identifying a source case for TB-exposed children is challenging. We examined the timepoint of obtaining source case TB contact information in HIV-infected and HIV-exposed uninfected (HEU) children in a randomized, placebo-controlled trial of pre-exposure isoniazid prophylaxis. Methods 543 HIV-infected and 808 HEU infants without TB exposure between 3 and 4 months of age were enrolled between 2004 and 2008. At 3 monthly follow-up, infants were evaluated for TB and caregivers were asked about new TB exposures. Results 128 cases of TB disease and 40 deaths were recorded, 19% (105/543) for HIV-infected and 8% (63/808) for HEU, 229 TB contact occasions were reported in 205/1351 (15%), (83%: 189/229) in the household. 53% of household contacts (108/189) had microbiological evaluations, 81% (87/108) were positive. HIV-infected and HEU infants had similar frequencies of TB contacts, reported in 48% with definite TB, 58% for probable TB, 43% for possible TB. Among 128 children diagnosed with TB, a TB contact was identified for 59. Of these, 29/59 (49%) were identified at or after child’s TB diagnosis. Conclusion TB source cases are often identified at or after a child’s TB diagnosis. More effort is required for earlier detection.

show abstract

Yield of contact tracing from pediatric tuberculosis index cases in Gaborone, Botswana

Cited by 23 publications

References 9 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

Outcomes of Community-Based Systematic Screening of Household Contacts of Patients with Multidrug-Resistant Tuberculosis in Myanmar

Source case identification in HIV-exposed infants and tuberculosis diagnosis in an isoniazid prevention study

Contact Info

Product

Resources

About