Risk-adjusted active tuberculosis case finding strategy in central Ethiopia.

Africa Contact tracing Household contacts Household members TB

Journal

IJID regions
ISSN: 2772-7076
Titre abrégé: IJID Reg
Pays: England
ID NLM: 9918418183106676

Informations de publication

Date de publication:
Jun 2022
Historique:
received: 21 01 2022
revised: 12 03 2022
accepted: 16 03 2022
entrez: 27 6 2022
pubmed: 28 6 2022
medline: 28 6 2022
Statut: epublish

Résumé

The World Health Organization recommends active case finding for tuberculosis (TB). Our study evaluated the targeted screening of household contacts (HHCs) of patients with contagious pulmonary tuberculosis (PTB) in Central Ethiopia. The HHCs of patients with microbiologically confirmed PTB were screened for TB symptoms and risk factors for TB transmission. Symptomatic HHCs were subjected to secondary investigation. Antimicrobial resistance was investigated among study participants. Overall, 112 index patients with TB were included, and 289 HHCs from 89 households were screened. Multidrug-resistant-TB was detected in 2.7% (n=3) of index patients. The routine public health system process did not identify any TB suspects among HHCs. In total, 23.9% (n=69) of HHCs reported ≥1 TB symptom and PTB was confirmed in 2.1% (n=6). Reporting >1 TB symptom (relative risk [RR] 29.4, 95% CI 3.5-245.5, The MDR-TB rate among our patients was higher than recently reported for Ethiopia. Enhanced contact tracing using a risk-adjusted approach seems feasible and increases the case detection rate among HHCs of confirmed TB cases.

Sections du résumé

Background UNASSIGNED
The World Health Organization recommends active case finding for tuberculosis (TB). Our study evaluated the targeted screening of household contacts (HHCs) of patients with contagious pulmonary tuberculosis (PTB) in Central Ethiopia.
Methods UNASSIGNED
The HHCs of patients with microbiologically confirmed PTB were screened for TB symptoms and risk factors for TB transmission. Symptomatic HHCs were subjected to secondary investigation. Antimicrobial resistance was investigated among study participants.
Results UNASSIGNED
Overall, 112 index patients with TB were included, and 289 HHCs from 89 households were screened. Multidrug-resistant-TB was detected in 2.7% (n=3) of index patients. The routine public health system process did not identify any TB suspects among HHCs. In total, 23.9% (n=69) of HHCs reported ≥1 TB symptom and PTB was confirmed in 2.1% (n=6). Reporting >1 TB symptom (relative risk [RR] 29.4, 95% CI 3.5-245.5,
Conclusion UNASSIGNED
The MDR-TB rate among our patients was higher than recently reported for Ethiopia. Enhanced contact tracing using a risk-adjusted approach seems feasible and increases the case detection rate among HHCs of confirmed TB cases.

Identifiants

pubmed: 35755475
doi: 10.1016/j.ijregi.2022.03.012
pii: S2772-7076(22)00040-6
pmc: PMC9216629
doi:

Types de publication

Journal Article

Langues

eng

Pagination

196-203

Informations de copyright

© 2022 The Authors.

Déclaration de conflit d'intérêts

All authors declare that they have no conflicts of interest.

Références

BMC Infect Dis. 2021 Feb 3;21(1):139
pubmed: 33535974
Semin Respir Crit Care Med. 2018 Jun;39(3):271-285
pubmed: 30071543
Lancet Infect Dis. 2008 Jun;8(6):359-68
pubmed: 18450516
Int J Tuberc Lung Dis. 2009 Nov;13(11):1399-404
pubmed: 19861013
BMC Infect Dis. 2017 Mar 16;17(1):214
pubmed: 28302070
J Infect Dev Ctries. 2021 Sep 29;15(9.1):75S-81S
pubmed: 34633786
Lancet Respir Med. 2020 Jan;8(1):19
pubmed: 31706931
New Microbes New Infect. 2022 Jan 17;45:100958
pubmed: 35242336
Ethiop J Health Sci. 2018 Sep;28(5):519-528
pubmed: 30607066
Arch Public Health. 2019 Jul 11;77:33
pubmed: 31333842
Int J Mycobacteriol. 2021 Oct-Dec;10(4):437-441
pubmed: 34916465
BMC Public Health. 2016 Jul 18;16:593
pubmed: 27430266
Lancet. 2019 Mar 30;393(10178):1331-1384
pubmed: 30904263

Auteurs

Andre Fuchs (A)

Hirsch Institute of Tropical Medicine, Asella, Ethiopia.
Internal Medicine III - Gastroenterology and Infectious Diseases, University Hospital of Augsburg, Augsburg, Germany.

Tafese Beyene Tufa (TB)

Hirsch Institute of Tropical Medicine, Asella, Ethiopia.
College of Health Sciences, Arsi University, Asella, Ethiopia.
Department of Gastroenterology, Hepatology and Infectious Diseases, Düsseldorf University Hospital, Heinrich Heine University, Moorenstr. 5, Düsseldorf 40225, Germany.

Frieder Pfäfflin (F)

Department for Infectious Diseases and Respiratory Medicine, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.

Andreas Schönfeld (A)

Department of Infectious Diseases, West German Centre of Infectious Diseases, Essen University Hospital, University of Duisburg-Essen, Essen, Germany.

Tamara Nordmann (T)

Department of Tropical Medicine, Bernhard Nocht Institute for Tropical Medicine & I. Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.

Fikru Melaku (F)

Adama Public Health Research and Referral Laboratory Center, Adama, Ethiopia.

Abebe Sorsa (A)

College of Health Sciences, Arsi University, Asella, Ethiopia.

Hans Martin Orth (HM)

Hirsch Institute of Tropical Medicine, Asella, Ethiopia.
Department of Gastroenterology, Hepatology and Infectious Diseases, Düsseldorf University Hospital, Heinrich Heine University, Moorenstr. 5, Düsseldorf 40225, Germany.

Dieter Häussinger (D)

Hirsch Institute of Tropical Medicine, Asella, Ethiopia.
Department of Gastroenterology, Hepatology and Infectious Diseases, Düsseldorf University Hospital, Heinrich Heine University, Moorenstr. 5, Düsseldorf 40225, Germany.

Tom Luedde (T)

Hirsch Institute of Tropical Medicine, Asella, Ethiopia.
Department of Gastroenterology, Hepatology and Infectious Diseases, Düsseldorf University Hospital, Heinrich Heine University, Moorenstr. 5, Düsseldorf 40225, Germany.

Torsten Feldt (T)

Hirsch Institute of Tropical Medicine, Asella, Ethiopia.
Department of Gastroenterology, Hepatology and Infectious Diseases, Düsseldorf University Hospital, Heinrich Heine University, Moorenstr. 5, Düsseldorf 40225, Germany.

Classifications MeSH