TY - JOUR
T1 - Age-specific prevalence of TB infection among household contacts of pulmonary TB
T2 - Is it time for TB preventive therapy?
AU - Dolla, Chandra Kumar
AU - Padmapriyadarsini, Chandrasekaran
AU - Thiruvengadam, Kannan
AU - Lokhande, Rahul
AU - Kinikar, Aarti
AU - Paradkar, Mandar
AU - Bm, Shrinivas
AU - Murali, Lakshmi
AU - Gupte, Akshay
AU - Gaikwad, Sanjay
AU - Selvaraju, Sriram
AU - Padmanaban, Yashoda
AU - Pattabiraman, Sathyamurthy
AU - Pradhan, Neeta
AU - Kulkarni, Vandana
AU - Shivakumar, Shri Vijay Bala Yogendra
AU - Prithivi, Munivardhan
AU - Kagal, Anju
AU - Karthavarayan, Barath Thopili
AU - Suryavanshi, Nishi
AU - Gupte, Nikhil
AU - Kumaran, Paul
AU - Mave, Vidya
AU - Gupta, Amita
N1 - Funding Information:
Funding: Data in this manuscript were collected as part of the Regional Prospective Observational Research for Tuberculosis (RePORT) India Consortium. This project has been funded in whole or in part with Federal funds from the Government of India’s (GOI) Department of Biotechnology (DBT), the Indian Council of Medical Research (ICMR), the United States National Institutes of Health (NIH), National Institute of Allergy and Infectious Diseases (NIAID), Office of AIDS Research (OAR), and distributed in part by Civilian Research Development Foundation (CRDF) Global. The research reported in this publication (analysis and manuscript preparation) was also supported by the NIH study, Impact of Diabetes on TB Treatment Outcomes (R01AI097494), the NIH Byramjee Jeejeebhoy Government Medical College HIV Clinical Trials Unit (UM1AI069497), and the Fogarty International Center, National Institutes of Health D43TW009574.
Funding Information:
Acknowledgements: We acknowledge support from Persistent Systems for IT support in kind, HP for computer donations, and the Ujala Foundation, Wyncote Foundation and Gilead Foundation.
Publisher Copyright:
© 2019 The Author(s).
PY - 2019/10/11
Y1 - 2019/10/11
N2 - 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.
AB - 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.
KW - close contacts
KW - force of infection
KW - latent TB
KW - transmission
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U2 - 10.1093/trstmh/trz049
DO - 10.1093/trstmh/trz049
M3 - Article
C2 - 31225622
AN - SCOPUS:85073183808
SN - 0035-9203
VL - 113
SP - 632
EP - 640
JO - Transactions of the Royal Society of Tropical Medicine and Hygiene
JF - Transactions of the Royal Society of Tropical Medicine and Hygiene
IS - 10
ER -