Literature DB >> 31225622

Age-specific prevalence of TB infection among household contacts of pulmonary TB: Is it time for TB preventive therapy?

Chandra Kumar Dolla1, Chandrasekaran Padmapriyadarsini2, Kannan Thiruvengadam1, Rahul Lokhande3, Aarti Kinikar4, Mandar Paradkar5, Shrinivas Bm2, Lakshmi Murali6, Akshay Gupte7, Sanjay Gaikwad3, Sriram Selvaraju1, Yashoda Padmanaban2, Sathyamurthy Pattabiraman2, Neeta Pradhan5, Vandana Kulkarni5, Shri Vijay Bala Yogendra Shivakumar8, Munivardhan Prithivi1, Anju Kagal9, Barath Thopili Karthavarayan1, Nishi Suryavanshi5,7, Nikhil Gupte5,7, Paul Kumaran1, Vidya Mave5,7, Amita Gupta7.   

Abstract

BACKGROUND: Household contacts (HHCs) of TB patients are at high risk of developing evidence of latent TB infection (LTBI) and active disease from the index patient. We estimated the age-specific prevalence of LTBI and the force of infection (FI), as a measure of recent transmission, among HHCs of active TB patients.
METHODS: A cross-sectional analysis of HHCs of pulmonary TB patients enrolled in a prospective study, 'CTRIUMPh', was conducted at two sites in India. LTBI was defined as either a positive tuberculin skin test (induration ≥5 mm) or QuantiFERON-Gold in tube test (value ≥0.35 IU/ml) and was stratified by age. FI, which is a measure of recent transmission of infection and calculated using changes in age-specific prevalence rates at specific ages, was calculated. Factors associated with LTBI were determined by logistic regression models.
RESULTS: Of 1020 HHCs of 441 adult pulmonary TB cases, there were 566 (55%) females and 289 (28%) children aged ≤15 y. While screening for the study 3% of HHC were diagnosed with active TB. LTBI prevalence among HHCs of pulmonary TB was 47% at <6 y, 53% between 6-14 y and 78% between 15-45 y. FI increased significantly with age, from 0.4 to 1.15 in the HHCs cohort (p=0.05).
CONCLUSION: This study observed an increased prevalence of LTBI and FI among older children and young adults recently exposed to infectious TB in the household. In addition to awareness of coughing etiquette and general hygiene, expanding access to TB preventive therapy to all HHCs, including older children, may be beneficial to achieve TB elimination by 2035.
© The Author(s) 2019. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Entities:  

Keywords:  close contacts; force of infection; latent TB; transmission

Year:  2019        PMID: 31225622      PMCID: PMC6792162          DOI: 10.1093/trstmh/trz049

Source DB:  PubMed          Journal:  Trans R Soc Trop Med Hyg        ISSN: 0035-9203            Impact factor:   2.184


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