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Investigation of household contacts of pulmonary tuberculosis patients increases case detection in Mwanza City, Tanzania

BACKGROUND: Tuberculosis (TB) contact tracing is a key strategy for containing TB and provides addition to the passive case finding approach. However, this practice has not been implemented in Tanzania, where there is unacceptably high treatment gap of 62.1% between cases estimated and cases detecte...

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Autores principales: Beyanga, Medard, Kidenya, Benson R., Gerwing-Adima, Lisa, Ochodo, Eleanor, Mshana, Stephen E., Kasang, Christa
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5840829/
https://www.ncbi.nlm.nih.gov/pubmed/29510670
http://dx.doi.org/10.1186/s12879-018-3036-6
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author Beyanga, Medard
Kidenya, Benson R.
Gerwing-Adima, Lisa
Ochodo, Eleanor
Mshana, Stephen E.
Kasang, Christa
author_facet Beyanga, Medard
Kidenya, Benson R.
Gerwing-Adima, Lisa
Ochodo, Eleanor
Mshana, Stephen E.
Kasang, Christa
author_sort Beyanga, Medard
collection PubMed
description BACKGROUND: Tuberculosis (TB) contact tracing is a key strategy for containing TB and provides addition to the passive case finding approach. However, this practice has not been implemented in Tanzania, where there is unacceptably high treatment gap of 62.1% between cases estimated and cases detected. Therefore calls for more aggressive case finding for TB to close this gap. We aimed to determine the magnitude and predictors of bacteriologically-confirmed pulmonary TB among household contacts of bacteriologically-confirmed pulmonary TB index cases in the city of Mwanza, Tanzania. METHODS: This study was carried out from August to December 2016 in Mwanza city at the TB outpatient clinics of Tertiary Hospital of the Bugando Medical Centre, Sekou-Toure Regional Hospital, and Nyamagana District Hospital. Bacteriologically-confirmed TB index cases diagnosed between May and July 2016 were identified from the laboratory registers book. Contacts were traced by home visits by study TB nurses, and data were collected using a standardized TB screening questionnaire. To detect the bacterioriologically-confirmed pulmonary TB, two sputum samples per household contact were collected under supervision for all household contacts following standard operating procedures. Samples were transported to the Bugando Medical Centre TB laboratory for investigation for TB using fluorescent smear microscopy, GeneXpert MTB/RIF and Löwenstein–Jensen (LJ) culture. Logistic regression was used to determine predictors of bacteriologically-confirmed pulmonary TB among household contacts. RESULTS: During the study period, 456 household contacts from 93 TB index cases were identified. Among these 456 household contacts, 13 (2.9%) were GeneXpert MTB/RIF positive, 18 (3.9%) were MTB-culture positive and four (0.9%) were AFB-smear positive. Overall, 29 (6.4%) of contacts had bacteriologically-confirmed pulmonary TB. Predictors of bacteriologically-confirmed pulmonary TB among household contacts were7being married (Odds ratio [OR], 3.3; 95% confidence interval [CI], 1.4–8.0; p = 0.012) and consuming less than three meals a day (OR, 3.7; 95% CI, 1.6–8.7; p = 0.009). CONCLUSIONS: Our data suggest that in Mwanza, Tanzania, seven in 100 contacts living in the same house with a TB patient develop bacteriologically-confirmed pulmonary TB. These results therefore underscore the need to implement routine TB contact tracing to control tuberculosis in high TB burden countries such as Tanzania.
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spelling pubmed-58408292018-03-14 Investigation of household contacts of pulmonary tuberculosis patients increases case detection in Mwanza City, Tanzania Beyanga, Medard Kidenya, Benson R. Gerwing-Adima, Lisa Ochodo, Eleanor Mshana, Stephen E. Kasang, Christa BMC Infect Dis Research Article BACKGROUND: Tuberculosis (TB) contact tracing is a key strategy for containing TB and provides addition to the passive case finding approach. However, this practice has not been implemented in Tanzania, where there is unacceptably high treatment gap of 62.1% between cases estimated and cases detected. Therefore calls for more aggressive case finding for TB to close this gap. We aimed to determine the magnitude and predictors of bacteriologically-confirmed pulmonary TB among household contacts of bacteriologically-confirmed pulmonary TB index cases in the city of Mwanza, Tanzania. METHODS: This study was carried out from August to December 2016 in Mwanza city at the TB outpatient clinics of Tertiary Hospital of the Bugando Medical Centre, Sekou-Toure Regional Hospital, and Nyamagana District Hospital. Bacteriologically-confirmed TB index cases diagnosed between May and July 2016 were identified from the laboratory registers book. Contacts were traced by home visits by study TB nurses, and data were collected using a standardized TB screening questionnaire. To detect the bacterioriologically-confirmed pulmonary TB, two sputum samples per household contact were collected under supervision for all household contacts following standard operating procedures. Samples were transported to the Bugando Medical Centre TB laboratory for investigation for TB using fluorescent smear microscopy, GeneXpert MTB/RIF and Löwenstein–Jensen (LJ) culture. Logistic regression was used to determine predictors of bacteriologically-confirmed pulmonary TB among household contacts. RESULTS: During the study period, 456 household contacts from 93 TB index cases were identified. Among these 456 household contacts, 13 (2.9%) were GeneXpert MTB/RIF positive, 18 (3.9%) were MTB-culture positive and four (0.9%) were AFB-smear positive. Overall, 29 (6.4%) of contacts had bacteriologically-confirmed pulmonary TB. Predictors of bacteriologically-confirmed pulmonary TB among household contacts were7being married (Odds ratio [OR], 3.3; 95% confidence interval [CI], 1.4–8.0; p = 0.012) and consuming less than three meals a day (OR, 3.7; 95% CI, 1.6–8.7; p = 0.009). CONCLUSIONS: Our data suggest that in Mwanza, Tanzania, seven in 100 contacts living in the same house with a TB patient develop bacteriologically-confirmed pulmonary TB. These results therefore underscore the need to implement routine TB contact tracing to control tuberculosis in high TB burden countries such as Tanzania. BioMed Central 2018-03-06 /pmc/articles/PMC5840829/ /pubmed/29510670 http://dx.doi.org/10.1186/s12879-018-3036-6 Text en © The Author(s). 2018 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Beyanga, Medard
Kidenya, Benson R.
Gerwing-Adima, Lisa
Ochodo, Eleanor
Mshana, Stephen E.
Kasang, Christa
Investigation of household contacts of pulmonary tuberculosis patients increases case detection in Mwanza City, Tanzania
title Investigation of household contacts of pulmonary tuberculosis patients increases case detection in Mwanza City, Tanzania
title_full Investigation of household contacts of pulmonary tuberculosis patients increases case detection in Mwanza City, Tanzania
title_fullStr Investigation of household contacts of pulmonary tuberculosis patients increases case detection in Mwanza City, Tanzania
title_full_unstemmed Investigation of household contacts of pulmonary tuberculosis patients increases case detection in Mwanza City, Tanzania
title_short Investigation of household contacts of pulmonary tuberculosis patients increases case detection in Mwanza City, Tanzania
title_sort investigation of household contacts of pulmonary tuberculosis patients increases case detection in mwanza city, tanzania
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5840829/
https://www.ncbi.nlm.nih.gov/pubmed/29510670
http://dx.doi.org/10.1186/s12879-018-3036-6
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