scholarly journals Tuberculosis contact investigation results among paediatric contacts in low-incidence settings in Finland

2021 ◽  
Author(s):  
Antti Kontturi ◽  
Satu Kekomäki ◽  
Eeva Ruotsalainen ◽  
Eeva Salo
Keyword(s):  
Early Diagnosis ◽  
Young Children ◽  
Large Scale ◽  
Index Case ◽  
Contact Tracing ◽  
Sputum Smear ◽  
Endemic Country ◽  
Household Contacts ◽  
Contact Investigation ◽  
Positive Index

AbstractTuberculosis (TB) risk is highest immediately after primary infection, and young children are vulnerable to rapid and severe TB disease. Contact tracing should identify infected children rapidly and simultaneously target resources effectively. We conducted a retrospective review of the paediatric TB contact tracing results in the Hospital District of Helsinki and Uusimaa from 2012 to 2016 and identified risk factors for TB disease or infection. Altogether, 121 index cases had 526 paediatric contacts of whom 34 were diagnosed with TB disease or infection. The maximum delay until first contact investigation visit among the household contacts under 5 years of age with either TB disease or infection was 7 days. The yield for TB disease or infection was 4.6% and 12.8% for household contacts, 0.5% and 0% for contacts exposed in a congregate setting and 1.4% and 5.0% for other contacts, respectively. Contacts born in a TB endemic country (aOR 3.07, 95% CI 1.10–8.57), with household exposure (aOR 2.96, 95% CI 1.33–6.58) or a sputum smear positive index case (aOR 3.96, 95% CI 1.20–13.03) were more likely to have TB disease or infection.Conclusions: Prompt TB investigations and early diagnosis can be achieved with a well-organised contact tracing structure. The risk for TB infection or disease was higher among contacts with household exposure, a sputum smear positive index case or born in a TB endemic country. Large-scale investigations among children exposed in congregate settings can result in a very low yield and should be cautiously targeted. What is Known:• Vulnerable young children are a high priority in contact tracing and should be evaluated as soon as possible after TB exposure What is New:• Prompt investigations for paediatric TB contacts and early diagnosis of infected children can be achieved with a well-organised contact tracing structure• Large-scale investigations among children exposed in congregate settings can result in a very low yield and should be cautiously targeted

The complication of cyber manhunt: How cyber manhunt further complicated the ethical conflict between breaching the confidentiality and endangering the society in face of the COVID-19 pandemic (Preprint)

2021 ◽  
Author(s):  
Yen-Chang Chen ◽  
Yen-Yuan Chen
Keyword(s):  
Public Health ◽  
Large Scale ◽  
Health Workers ◽  
Early Stage ◽  
Personal Information ◽  
Public Health Intervention ◽  
Contact Tracing ◽  
Online Activity ◽  
Contact Investigation ◽  
The Impact

UNSTRUCTURED While health care and public health workers are working on measures to mitigate the COVID-19 pandemic, there is an unprecedentedly large number of people spending much more time indoors, and relying heavily on the Internet as their lifeline. What has been overlooked is the influence of the increasing online activities on public health issues. In this article, we pointed out how a large-scale online activity called cyber manhunt may threaten to offset the efficacy of contact tracing investigation, a public health intervention considered highly effective in limiting further transmission in the early stage of a highly contagious disease outbreak such as the COVID-19 pandemic. In the first section, we presented a case to show how personal information obtained from contact investigation and disclosed in part on the media provoked a vehement cyber manhunt. We then discussed the possible reasons why netizens collaborate to reveal anonymized personal information about contact investigation, and specify, from the perspective of public health and public health ethics, four problems of cyber manhunt, including the lack of legitimate public health goals, the concerns about privacy breach, the impact of misinformation, and social inequality. Based on our analysis, we concluded that more moral weight may be given to protecting one's confidentiality, especially in an era with the rapid advance of digital and information technologies.

scholarly journals Expanding Tuberculosis Case Detection by Screening Household Contacts

2005 ◽  
Vol 120 (3) ◽  
pp. 271-277 ◽  
Author(s):  
Mercedes C. Becerra ◽  
Iliana F. Pachao-Torreblanca ◽  
Jaime Bayona ◽  
Rosa Celi ◽  
Sonya S. Shin ◽  
...  
Keyword(s):  
Risk Factors ◽  
Case Finding ◽  
Self Report ◽  
Contact Tracing ◽  
Sputum Smear ◽  
Case Detection ◽  
Active Case Finding ◽  
Active Case ◽  
Tb Control ◽  
Household Contacts

Objectives. Tuberculosis (TB) case detection remains low in many countries, compromising the efficacy of TB control efforts. Current global TB control policy emphasizes case finding through sputum smear microscopy for patients who self-report to primary health centers. Our objective was to assess the feasibility and yield of a simple active case finding strategy in a high incidence population in northern Lima, Peru. Methods. We implemented this pilot strategy in one health center's catchment area. Health workers visited household contacts of new TB case subjects to identify symptomatic individuals and collect sputum for screening. Neighboring households were screened in the same manner. Secondary analyses measured risk of TB by ( 1) sputum smear status of the index case subject, ( 2) compliance with testing, and ( 3) risk factors for disease detected through active contact tracing in contrast to self-report. Results. The TB prevalence detected through combined active and passive case finding among 1,094 household contacts was 0.91% (914 per 100,000), much higher than with passive case finding alone (0.18%; 183 per 100,000; p=0.02). Among 2,258 neighbors, the combined strategy detected a TB prevalence of 0.22% (221 per 100,000) in contrast to 0.08% (80 per 100,000) detected through passive case finding alone ( p=0.25). Risk factors for being diagnosed through active case finding in contrast with self-report included age >55 years (odds ratio [OR]=5.5; 95% confidence interval [CI] 1.2, 22.8) and female gender (OR=3.9; 95% CI 0.99, 22.3). Conclusions. Risk of active TB among symptomatic household contacts of active case subjects in this community is very high. Results suggest that contact tracing in such settings may be a powerful means of improving case detection rates for active TB disease.

scholarly journals Quantitative PCR for leprosy diagnosis and monitoring in household contacts: A follow-up study, 2011–2018

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Fernanda S. N. Manta ◽  
Raquel R. Barbieri ◽  
Suelen J. M. Moreira ◽  
Paulo T. S. Santos ◽  
José A. C. Nery ◽  
...  
Keyword(s):  
Early Diagnosis ◽  
Skin Diseases ◽  
Survival Rates ◽  
Disease Free Survival ◽  
Skin Lesions ◽  
Contact Tracing ◽  
Household Contacts ◽  
Leprosy Patients ◽  
Skin Biopsies

Abstract Household contacts (HHC) of leprosy patients exhibit high-risk of developing leprosy and contact tracing is helpful for early diagnosis. From 2011 to 2018,2,437 HHC were examined in a clinic in Rio de Janeiro, Brazil and 16S qPCR was used for diagnosis and monitoring of contacts. Fifty-four HHCs were clinically diagnosed with leprosy at intake. Another 25 exhibited leprosy-like skin lesions at intake, 8 of which were confirmed as having leprosy (50% of which were qPCR positive) and 17 of which were diagnosed with other skin diseases (6% qPCR positive). In skin biopsies, qPCR presented a sensitivity of 0.50 and specificity of 0.94. Furthermore, 955 healthy HHCs were followed-up for at least 3 years and skin scrapings were collected from earlobes for qPCR detection. Positive qPCR indicated a non-significant relative risk of 2.52 of developing the disease. During follow-up, those who progressed towards leprosy exhibited 20% qPCR positivity, compared to 9% of those who remained healthy. Disease-free survival rates indicated that age had a significant impact on disease progression, where patients over 60 had a greater chance of developing leprosy [HR = 32.4 (3.6–290.3)]. Contact tracing combined with qPCR may assist in early diagnosis and age is a risk factor for leprosy progression.

scholarly journals High prevalence of clustered tuberculosis cases in Peruvian migrants in Florence, Italy

2014 ◽  
Vol 6 (4) ◽  
Author(s):  
Lorenzo Zammarchi ◽  
Enrico Tortoli ◽  
Emanuele Borroni ◽  
Filippo Bartalesi ◽  
Marianne Strohmeyer ◽  
...  
Keyword(s):  
Mycobacterium Tuberculosis ◽  
Retrospective Study ◽  
Early Diagnosis ◽  
Index Case ◽  
Contact Tracing ◽  
High Prevalence

Tuberculosis is a leading cause of morbidity for Peruvian migrants in Florence, Italy, where they account for about 20% of yearly diagnosed cases. A retrospective study on cases notified in Peruvian residents in Florence in the period 2001-2010 was carried out and available <em>Mycobacterium tuberculosis</em> strains were genotyped (MIRU-VNTR-24 and Spoligotyping). One hundred thirty eight cases were retrieved. Genotyping performed in 87 strains revealed that 39 (44.8%) belonged to 12 clusters. Assuming that in each cluster the transmission of tuberculosis from the index case took place in Florence, a large proportion of cases could be preventable by improving early diagnosis of contagious cases and contact tracing.

scholarly journals Evaluation of TB Case Finding through Systematic Contact Investigation, Chhattisgarh, India

2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
Kshitij Khaparde ◽  
Pawan Jethani ◽  
Puneet K. Dewan ◽  
Sreenivas A. Nair ◽  
Madhav Rao Deshpande ◽  
...  
Keyword(s):  
Clinical Symptoms ◽  
Standard Procedure ◽  
National Policy ◽  
Health Care Facilities ◽  
Public Health Care ◽  
Sputum Smear ◽  
Smear Microscopy ◽  
Case Detection ◽  
Household Contacts ◽  
Contact Investigation

Rationale. Contact investigation is an established tool for early case detection of tuberculosis (TB). In India, contact investigation is not often conducted, despite national policy, and the yield of contact investigation is not well described.Objective. To determine the yield of evaluating household contacts of sputum smear-positive TB cases in Rajnandgaon district, Chhattisgarh, India.Methods. Among 14 public health care facilities with sputum smear microscopy services, home visits were conducted to identify household contacts of all registered sputum smear-positive TB cases. We used a standardized protocol to screen for clinical symptoms suggestive of active TB with additional referral for chest radiograph and sputa collection.Results. From December 2010 to May 2011, 1,556 household contacts of 312 sputum smear-positive TB cases were identified, of which 148 (9.5%) were symptomatic. Among these, 109 (73.6%) were evaluated by sputum examination resulting in 11 cases (10.1%) of sputum smear-positive TB and 4 cases (3.6%) of smear-negative TB. Household visits contributed additional 63% TB cases compared to passive case detection alone.Conclusion. A standard procedure for conducting household contact investigation identified additional TB cases in the community and offered an opportunity to initiate isoniazid chemoprophylaxis among children.

scholarly journals Tuberculosis outbreak associated with a mosque: challenges of large scale contact tracing

2008 ◽  
Vol 13 (51) ◽  
Author(s):  
S Duthie ◽  
C Black ◽  
G Douglas ◽  
A D Jackson ◽  
D Webster
Keyword(s):  
Large Scale ◽  
Communication Strategy ◽  
High Rate ◽  
Contact Tracing ◽  
Sputum Smear ◽  
Genetic Profile ◽  
Adult Males ◽  
North East ◽  
The North ◽  
Prayer Meetings

In this report, we describe the investigation and management of an outbreak of TB associated with a mosque in Scotland, and consider the implications of large-scale TB contact tracing. In 2005, an Algerian man living in the north-east of Scotland was found to be sputum smear-positive for TB. Initial investigation identified three (18.8%) close contacts with active disease. Due to the high rate of transmission, contact tracing was extended to casual contacts of the index case at a mosque. No sub-group at highest risk of exposure could be defined at the mosque. Screening of mosque attendees identified two cases (0.53%), with a further two identified by review of existing cases and enhanced surveillance. Two additional cases were linked to the outbreak by genetic profile. Response to the screening exercise was initially poor, but after modification of the communication strategy, 438 people were offered screening with 86% attending. The investigation and management of a TB outbreak is challenging and requires a complex message about risk to be communicated. In a mosque setting, there were additional complexities that, to the best of our knowledge, have not been reported previously. It was crucial, in designing the communication strategy, to identify key individuals within the community to assist with tailoring the message to address risk perception and to help to deliver the message. Despite this, approximately 50% of those considered to have the highest exposure (adult males regularly attending Friday lunchtime prayer meetings) did not come forward for screening. The screening of casual contacts in this setting was complex and time-consuming with a low detection rate.

scholarly journals Vaccine effectiveness against SARS-CoV-2 transmission to household contacts during dominance of Delta variant (B.1.617.2), the Netherlands, August to September 2021

2021 ◽  
Vol 26 (44) ◽  
Author(s):  
Brechje de Gier ◽  
Stijn Andeweg ◽  
Jantien A Backer ◽  
Susan JM Hahné ◽  
Susan van den Hof ◽  
...  
Keyword(s):  
The Netherlands ◽  
Confidence Interval ◽  
Index Case ◽  
Vaccine Effectiveness ◽  
Contact Tracing ◽  
Household Contacts ◽  
Household Members ◽  
Index Cases

We estimated SARS-CoV-2 vaccine effectiveness against onward transmission by comparing secondary attack rates among household members for vaccinated and unvaccinated index cases, based on source and contact tracing data collected when the Delta variant was dominant. Effectiveness of full vaccination of the index case against transmission to unvaccinated and fully vaccinated household contacts, respectively, was 63% (95% confidence interval (CI): 46–75) and 40% (95% CI: 20–54), in addition to the direct protection of vaccination of contacts against infection.

scholarly journals Utility of early diagnosis, contact tracing and stakeholder engagement in outbreak response in three COVID-19 outbreak settings in Ghana

2021 ◽  
Vol 55 (2) ◽  
pp. 29-37
Author(s):  
Mary Amoakoh-Coleman ◽  
Delia A. Bandoh ◽  
Charles L. Noora ◽  
Holy Alomatu ◽  
Abraham Baidoo ◽  
...  
Keyword(s):  
Early Diagnosis ◽  
Stakeholder Engagement ◽  
Index Case ◽  
Contact Tracing ◽  
Training Institution ◽  
Outbreak Response ◽  
Factory Workers ◽  
Early Case ◽  
Early Case Detection ◽  
Index Cases

Objective: To describe how early case detection, testing and contact tracing measures were deployed by stakeholders in response to the COVID-19 outbreak in Ghana – using three outbreak scenarios.Design: A descriptive assessment of three case studies of COVID-19 outbreaks within three settings that occurred in Ghana from March 13 till the end of June 2020.Setting: A construction camp, a factory and a training institution in Ghana.Participants: Staff of a construction camp, a factory, workers and students of a training institution.Interventions: We described and compared the three COVID-19 outbreak scenarios in Ghana, highlighting identification and diagnosis of cases, testing, contact tracing and stakeholder engagement for each scenario. We also outlined the challenges and lessons learnt in the management of these scenarios.Main outcome measures: Approach used for diagnosis, testing, contact tracing and stakeholder engagement.Results: Index cases of the training institution and construction camp were screened the same day of reporting symptoms, whiles the factory index case required a second visit before the screening. All index cases were tested with RTPCR. The training institution followed and tested all contacts, and an enhanced contact tracing approach was conducted for staff of the other two sites. Multi-sectorial engagement and collaboration with stakeholders enabled effectivehandling of the outbreak response in all sites.Conclusion: Comparing all three settings, early diagnosis and prompt actions taken through multi-sectorial collaborations played a major role in controlling the outbreak. Engaging stakeholders in the COVID-19 response is an effective way to mitigate the challenges in responding to the pandemic.

scholarly journals Isoniazid preventive therapy in child household contacts of adults with active TB in Bamako, Mali

2021 ◽  
Vol 11 (4) ◽  
pp. 191-195
Author(s):  
M. Tolofoudie ◽  
A. Somboro ◽  
B. Diarra ◽  
Y. S. Sarro ◽  
H. B. Drame ◽  
...  
Keyword(s):  
Adverse Events ◽  
Index Case ◽  
Preventive Therapy ◽  
Completion Rate ◽  
Isoniazid Preventive Therapy ◽  
Newly Diagnosed ◽  
Good Adherence ◽  
Legal Guardian ◽  
Household Contacts ◽  
Positive Index

BACKGROUND and OBJECTIVE: Isoniazid preventive therapy (IPT) is known to reduce the risk of developing active TB in about 59% in children aged 15 years. We assessed adherence, completion and adverse events among children who were household contacts of a newly diagnosed adult with smear-positive TB in Bamako, Mali.METHODS: Children aged <15 years living in the same house with an adult smear-positive index case were enrolled in the study in the Bamako Region after consent was obtained from the parent or legal guardian. Adherence was assessed based on the number of tablets consumed during 6 months.RESULTS: A total of 260 children aged <15 years were identified as household contacts of 207 adult patients with smear-positive TB during the study period. Among all child contacts, 130/260 (50.0%) were aged 0–4 years and were eligible for IPT; 128/130 (98.5%) were started on IPT and 83/128 (64.8%) completed with good adherence at the end of the 6 months, and without any significant adverse events.CONCLUSION: We successfully implemented IPT with good acceptance, but low completion rate. The Mali National TB Program and partners should expand this strategy to reach more children in Bamako and the whole country and create greater awareness in the population.

scholarly journals Analytical Validation and Clinical Application of Rapid Serological Tests for SARS-CoV-2 Suitable for Large-Scale Screening

Diagnostics ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. 869
Author(s):  
Amedeo De Nicolò ◽  
Valeria Avataneo ◽  
Jessica Cusato ◽  
Alice Palermiti ◽  
Jacopo Mula ◽  
...  
Keyword(s):  
Early Diagnosis ◽  
Real Time Pcr ◽  
Large Scale ◽  
High Sensitivity ◽  
Analytical Validation ◽  
Pcr Assay ◽  
Serological Tests ◽  
Flow Test ◽  
Lateral Flow Test ◽  
Large Scale Screening

Recently, large-scale screening for COVID-19 has presented a major challenge, limiting timely countermeasures. Therefore, the application of suitable rapid serological tests could provide useful information, however, little evidence regarding their robustness is currently available. In this work, we evaluated and compared the analytical performance of a rapid lateral-flow test (LFA) and a fast semiquantitative fluorescent immunoassay (FIA) for anti-nucleocapsid (anti-NC) antibodies, with the reverse transcriptase real-time PCR assay as the reference. In 222 patients, LFA showed poor sensitivity (55.9%) within two weeks from PCR, while later testing was more reliable (sensitivity of 85.7% and specificity of 93.1%). Moreover, in a subset of 100 patients, FIA showed high sensitivity (89.1%) and specificity (94.1%) after two weeks from PCR. The coupled application for the screening of 183 patients showed satisfactory concordance (K = 0.858). In conclusion, rapid serological tests were largely not useful for early diagnosis, but they showed good performance in later stages of infection. These could be useful for back-tracing and/or to identify potentially immune subjects.

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