scholarly journals Excess Risk of Tuberculosis Infection Among Extra-household Contacts of Tuberculosis Cases in an African City

2020 ◽  
Author(s):  
Robert Kakaire ◽  
Noah Kiwanuka ◽  
Sarah Zalwango ◽  
Juliet N Sekandi ◽  
Trang Ho Thu Quach ◽  
...  
Keyword(s):  
Cross Sectional Study ◽  
Excess Risk ◽  
Tuberculosis Infection ◽  
African City ◽  
Cross Sectional ◽  
Control Networks ◽  
Household Contacts ◽  
Prevalence Difference ◽  
And Control ◽  
Index Cases

Abstract Background Although households of tuberculosis (TB) cases represent a setting for intense transmission of Mycobacterium tuberculosis, household exposure accounts for <20% of transmission within a community. The aim of this study was to estimate excess risk of M. tuberculosis infection among household and extra-household contacts of index cases. Methods We performed a cross-sectional study in Kampala, Uganda, to delineate social networks of TB cases and matched controls without TB. We estimated the age-stratified prevalence difference of TB infection between case and control networks, partitioned as household and extra-household contacts. Results We enrolled 123 index cases, 124 index controls, and 2415 first-degree network contacts. The prevalence of infection was highest among household contacts of cases (61.5%), lowest among household contacts of controls (25.2%), and intermediary among extra-household TB contacts (44.9%) and extra-household control contacts (41.2%). The age-adjusted prevalence difference between extra-household contacts of cases and their controls was 5.4%. The prevalence of infection was similar among the majority of extra-household case contacts and corresponding controls (47%). Conclusions Most first-degree social network members of TB cases do not have adequate contact with the index case to experience additional risk for infection, but appear instead to acquire infection through unrecognized exposures with infectious cases in the community.

scholarly journals Isoniazid Preventative Therapy uptake for child household contacts of tuberculosis index cases, Kisumu County, Kenya, 2014-2015

2019 ◽  
Vol 10 (1) ◽  
Author(s):  
Barbara Burmen ◽  
Kennedy Mutai ◽  
Timothy Malika
Keyword(s):  
Cross Sectional Study ◽  
Diagnostic Tools ◽  
Case Detection ◽  
Preventative Therapy ◽  
Cross Sectional ◽  
Worker Training ◽  
Household Contacts ◽  
Isoniazid Preventative Therapy ◽  
Pediatric Tb ◽  
Index Cases

Isoniazid Preventative Therapy (IPT) is recommended for children aged less than 5 years that have been in contact with an open case of TB, and screen negative for TB, to prevent the risk of TB progression. We examined IPT uptake among child household contacts of TB index cases, within a TB case detection study, in a high TB burden region. A cross-sectional study involving all IPT-eligible children drawn from a TB case detection study was done in Kisumu County, Kenya between 2014 and 2015. By linking a subset of the study database to the TB program IPT register, we described Child contacts as initiated on IPT and TB index cases as having child contacts initiated on IPT based on whether their names or their child contacts names respectively, were found in the IPT register. Logistic regression analysis was used to describe index and contact characteristics associated with IPT initiation. Of 555 TB index cases recruited into the study, 243 (44%) had a total of 337 IPT-eligible child contacts. Forty-seven (19%) index cases that had child contacts initiated on IPT; they were more likely to have been diagnosed with smear positive TB compared to those who were diagnosed with smear negative TB (OR 5.1, 95% CI 1.1-23.2; P=0.03) and to reside in rural Kisumu compared to those in urban Kisumu (OR 3.3, 95% CI 1.6-6.8; P<0.01). The 51 (15%) child contacts that were initiated on IPT were more likely to be were first degree relatives of the index case compared to those who were not (OR 2.6, 95% CI 1.2-5.5; P=0.02) and to reside in rural Kisumu compared to those in urban Kisumu (OR 2.6, 95% CI 1.2-5.1; P<0.01). IPT initiation, which is influenced by index and contact characteristics, is suboptimal. The TB program should provide health worker training, avail appropriate pediatric TB diagnostic tools, job aids and monitoring tools, and ensure continuous supply of medication, and to facilitate IPT implementation. Additionally, targeted health education interventions should be formulated to reach those who are unlikely to accept IPT.

scholarly journals Isoniazid preventative therapy uptake for child household contacts of TB index cases, Kisumu County, Kenya, 2014-2015

2018 ◽  
Vol 9 (1) ◽  
Author(s):  
Barbara Burmen ◽  
Kennedy Mutai ◽  
Timothy Malika
Keyword(s):  
Cross Sectional Study ◽  
Diagnostic Tools ◽  
Case Detection ◽  
Preventative Therapy ◽  
Cross Sectional ◽  
Worker Training ◽  
Household Contacts ◽  
Isoniazid Preventative Therapy ◽  
Pediatric Tb ◽  
Index Cases

Background Isoniazid Preventative Therapy (IPT) is recommended for children aged less than 5 years that have been in contact with an open case of TB and screen negative for TB to prevent the risk of TB progression. We examined IPT uptake among child household contacts of TB index cases within a TB case detection study in a high TB burden region. Methods A cross-sectional study involving all IPT eligible children drawn from a TB case detection study was done in Kisumu County, Kenya between 2014 and 2015. By linking a subset study database to the TB program IPT register, we described Child contacts as ‘initiated on IPT’ and TB index cases as ‘having child contacts initiated on IPT’ based on whether their names or their child contacts names respectively, were found in the IPT register. Logistic regression analysis was used to describe index and contact characteristics associated with IPT initiation Results Of 555 TB index cases into the study, 243 (44%) had a total of 337 IPT-eligible child household contacts. Forty-seven (19%) index cases that had child contacts initiated on IPT; they were more likely to have been diagnosed with smear positive TB compared to those who were diagnosed with smear negative TB (OR 5.1, 95% CI 1.1-23.2; p=0.03) and to reside in rural Kisumu compared to those in urban Kisumu (OR 3.3, 05% CI 1.6-6.8; p<0.01). The 51 (15%) child contacts that were initiated on IPT were more likely to be were first degree relatives of the index case compared to those who were not (OR 2.6, 95% CI 1.2-5.5; p=0.02) and to reside in rural Kisumu compared to those in urban Kisumu (OR 2.6, 95% CI 1.2-5.1; p<0.01). Conclusion IPT initiation, which is influenced by index and contact characteristics, is suboptimal. The TB program should provide health worker training, avail appropriate pediatric TB diagnostic tools and continuous supply of medication, and job aids and monitoring tools to facilitate IPT implementation. Additionally, targeted health education interventions should be formulated to reach those who are unlikely to accept IPT.

scholarly journals TUBERCULOUS PATIENTS;

2013 ◽  
Vol 20 (05) ◽  
pp. 678-683
Author(s):  
NASIR AZIZ ◽  
HAMID MAHMOOD ◽  
HASHIM RIAZ ◽  
Zahid Mahmood ◽  
Akhtar Murad Qadir ◽  
...  
Keyword(s):  
Cross Sectional Study ◽  
Sectional Study ◽  
Control Groups ◽  
Cross Sectional ◽  
Bcg Vaccination ◽  
Household Contacts ◽  
Study Materials ◽  
Significant Difference ◽  
Immune Globulins ◽  
And Control

Objective: This study was designed to analyze the BCG vaccination status and compare the immune globulins levels in thehousehold contacts of tuberculous patients with non contacts of unexposed healthy peoples. Place: Gulab Devi Hospital, Post GraduateMedical Institute and Defense Housing Authority Lahore. Study design: Cross sectional study. Materials and Methods: Investigationslike ESR were done and the sera of 200 persons included in the study were tested for anti tuberculous antibodies by ELISA. BCGvaccination present or absent and scars were positive or negative in both groups were included. Results: The combined serologicalpositivity of the household contacts was 65.8% and for non-contacts was 34.1%. BCG scars were mostly absent in the householdcontacts as well as in non-contacts; But statistically IgG and IgA were present significantly by higher number in the household contacts ascompared to non-contacts, where as no significant difference in the IgM levels. These immunoglobulins status were compared with BCGscars in both study and control groups. The results were analyzed by SPSS version 14. Conclusions: Household contacts of tuberculosispatients are more susceptible to tuberculosis as compared to the non-contacts, as shown by positive and negative status ofantituberculous antibodies in the house hold contacts. More over BCG vaccination has no significant role in humoral evaluation.

scholarly journals On the SARS-CoV-2 “Variolation Hypothesis”: No Association Between Viral Load of Index Cases and COVID-19 Severity of Secondary Cases

2021 ◽  
Vol 12 ◽  
Author(s):  
Mattia Trunfio ◽  
Bianca Maria Longo ◽  
Francesca Alladio ◽  
Francesco Venuti ◽  
Francesco Cerutti ◽  
...  
Keyword(s):  
Viral Load ◽  
Cross Sectional Study ◽  
Pharyngeal Swab ◽  
Cross Sectional ◽  
Household Contacts ◽  
Negative Findings ◽  
Novel Coronavirus ◽  
Public Health Strategies ◽  
Index Cases ◽  
Exact Quantification

Background: Emerging evidence supports the “variolation hypothesis” in severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), but the derivative idea that the viral load of index cases may predict disease severity in secondary cases could be unsubstantiated. We assessed whether the prevalence of symptomatic infections, hospitalization, and deaths in household contacts of 2019 novel coronavirus disease (COVID-19) cases differed according to the SARS-CoV-2 PCR cycle threshold (Ct) from nasal-pharyngeal swab at diagnosis of linked index cases.Methods: Cross-sectional study on household contacts of COVID-19 cases randomly sampled from all the infections diagnosed in March at our Microbiology Laboratory (Amedeo di Savoia, Turin). Data were retrospectively collected by phone interviews and from the Piedmont regional platform for COVID-19 emergency. Index cases were classified as high (HVl) and low viral load (LVl) according to two exploratory cut-offs of RdRp gene Ct value. Secondary cases were defined as swab confirmed or symptom based likely when not tested but presenting compatible clinical picture.Results: One hundred thirty-two index cases of whom 87.9% symptomatic and 289 household contacts were included. The latter were male and Caucasian in 44.3 and 95.8% of cases, with a median age of 34 years (19–57). Seventy-four were swab confirmed and other 28 were symptom based likely secondary cases. Considering both, the contacts of HVl and LVl did not differ in the prevalence of symptomatic infections nor COVID-19-related hospitalization and death. No difference in median Ct of index cases between symptomatic and asymptomatic, hospitalized and not hospitalized, or deceased and survived secondary cases was found. Negative findings were confirmed after adjusting for differences in time between COVID-19 onset and swab collection of index cases (median 5 days) and after removing pediatric secondary cases.Conclusions: The amount of SARS-CoV-2 of the source at diagnosis does not predict clinical outcomes of linked secondary cases. Considering the impelling release of assays for SARS-CoV-2 RNA exact quantification, these negative findings should inform clinical and public health strategies on how to interpret and use the data.

scholarly journals Willingness to Take Multidrug-resistant Tuberculosis (MDR-TB) Preventive Therapy Among Adult and Adolescent Household Contacts of MDR-TB Index Cases: An International Multisite Cross-sectional Study

2019 ◽  
Vol 70 (3) ◽  
pp. 436-445
Author(s):  
Nishi Suryavanshi ◽  
Matthew Murrill ◽  
Amita Gupta ◽  
Michael Hughes ◽  
Anneke Hesseling ◽  
...  
Keyword(s):  
Multidrug Resistant ◽  
Cross Sectional Study ◽  
Preventive Therapy ◽  
Sectional Study ◽  
Cross Sectional ◽  
Household Contacts ◽  
Resistant Tuberculosis ◽  
Multidrug Resistant Tuberculosis ◽  
Mdr Tb ◽  
Index Cases

Abstract Background Household contacts (HHCs) of individuals with multidrug-resistant tuberculosis (MDR-TB) are at high risk of infection and subsequent disease. There is limited evidence on the willingness of MDR-TB HHCs to take MDR-TB preventive therapy (MDR TPT) to decrease their risk of TB disease. Methods In this cross-sectional study of HHCs of MDR-TB and rifampicin-resistant tuberculosis (RR-TB) index cases from 16 clinical research sites in 8 countries, enrollees were interviewed to assess willingness to take a hypothetical, newly developed MDR TPT if offered. To identify factors associated with willingness to take MDR TPT, a marginal logistic model was fitted using generalized estimating equations to account for household-level clustering. Results From 278 MDR-TB/RR-TB index case households, 743 HHCs were enrolled; the median age of HHCs was 33 (interquartile range, 22–49) years, and 62% were women. HHC willingness to take hypothetical MDR TPT was high (79%) and remained high even with the potential for mild side effects (70%). Increased willingness was significantly associated with current employment or schooling (adjusted odds ratio [aOR], 1.83 [95% confidence interval {CI}, 1.07–3.13]), appropriate TB-related knowledge (aOR, 2.22 [95% CI, 1.23–3.99]), confidence in taking MDR TPT (aOR, 7.16 [95% CI, 3.33–15.42]), and being comfortable telling others about taking MDR TPT (aOR, 2.29 [95% CI, 1.29–4.06]). Conclusions The high percentage of HHCs of MDR-TB/RR-TB index cases willing to take hypothetical MDR TPT provides important evidence for the potential uptake of effective MDR TPT when implemented. Identified HHC-level variables associated with willingness may inform education and counseling efforts to increase HHC confidence in and uptake of MDR TPT.

scholarly journals Increased Transmissibility of the SARS-CoV-2 Alpha Variant in a Japanese Population

2021 ◽  
Vol 18 (15) ◽  
pp. 7752
Author(s):  
Hideo Tanaka ◽  
Atsushi Hirayama ◽  
Hitomi Nagai ◽  
Chika Shirai ◽  
Yuki Takahashi ◽  
...  
Keyword(s):  
Japanese Population ◽  
Error Variance ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Fourth Group ◽  
Household Contacts ◽  
The Third ◽  
Before And After ◽  
Alpha Variant ◽  
Index Cases

To assess the relative transmissibility of the SARS-CoV-2 Alpha variant compared to the pre-existing SARS-CoV-2 in Japan, we performed a cross-sectional study to determine the secondary attack rate of COVID-19 in household contacts before and after the Alpha variant became dominant in Osaka. We accessed 290 household contacts whose index cases were diagnosed between 1 and 20 December 2020 (the third epidemic group), at a time when Osaka was free of the Alpha variant. We also accessed 398 household contacts whose index cases were diagnosed between 20 April and 3 May 2021 (the fourth epidemic group), by which time the Alpha variant had become dominant. We identified 124 household contacts whose index case was determined positive for the Alpha variant (Alpha group) in this fourth group. The secondary attack rates in the fourth group (34.7%) and the Alpha group (38.7%) were significantly higher than that in the third group (19.3%, p < 0.001). Multivariable Poisson regression analysis with a robust error variance showed a significant excess risk in the fourth group (1.90, 95% CI = 1.47–2.48) and the Alpha group (2.34, 95% CI = 1.71–3.21). This finding indicates that the SARS-CoV-2 Alpha variant has an approximately 1.9–2.3-fold higher transmissibility than the pre-existing virus in the Japanese population.

scholarly journals Performance of GeneXpert MTB/RIF for diagnosing tuberculosis among symptomatic household contacts of index patients in South Africa

2021 ◽  
Author(s):  
Kavindhran Velen ◽  
Laura J Podewils ◽  
N Sarita Shah ◽  
James J Lewis ◽  
Tiro Dinake ◽  
...  
Keyword(s):  
South Africa ◽  
Test Performance ◽  
Predictive Value ◽  
Poor Performance ◽  
Cross Sectional Study ◽  
Smear Microscopy ◽  
Cross Sectional ◽  
Household Contacts ◽  
Mgit Culture ◽  
Index Cases

Abstract Background We describe the performance of GeneXpert MTB/RIF (Xpert) for diagnosing tuberculosis (TB) among symptomatic household contacts (HHCs) of rifampicin-resistant and drug-sensitive index cases. Methods We conducted a cross-sectional study among HHCs of recently diagnosed (&lt;2 weeks) smear-positive and Xpert-positive index cases in the Bojanala District, South Africa. HHCs were screened for TB symptoms; persons with ≥1 TB symptom provided one sputum for smear microscopy, Xpert and MGIT culture. Diagnostic test performance of Xpert was determined using MGIT as reference standard. Results From August 2013 to July 2015, 619 HHCs from 216 index cases were enrolled: 60.6% were female, median age was 22 years (inter-quartile range: 9, 40) and 126 (20.4%) self-reported/tested HIV-positive. 54.3% (336/619) of contacts had ≥1 TB symptom (cough, fever, night sweats, weight loss), of which 297/336 (88.4%) provided a sputum; 289 (97.3%) had complete testing and 271 were included in the analysis. In total, 42 (6.8%) of 619 HHCs had microbiologically-confirmed TB. MGIT identified 33 HHCs as positive for Mycobacterium tuberculosis (MTB); of these, 7 were positive on Xpert resulting in a sensitivity of 21.2% (95% confidence interval [CI]: 9.0, 38.9), specificity 98.3% (95% CI: 95.6, 99.5), positive predictive value (PPV) 63.6% (95% CI: 30.8, 89.1), negative predictive value (NPV) 90.0 (95% CI: 85.7, 93.4). Conclusions Among symptomatic HHCs investigated for TB, Xpert performed sub-optimally compared to MGIT culture. The poor performance of Xpert for diagnosing TB suggests that a more sensitive test, such a Xpert Ultra or culture, may be needed to improve yield of contact investigation, where feasible.

ROLE OF PHARMACIST INTERVENTION ON COPD PATIENTS OF SELECTED AREAS IN CHITRADURGA: A KAP STUDY

2019 ◽  
Vol 8 (2) ◽  
Author(s):  
Melvin K Mathews ◽  
Abubaker Siddiq ◽  
Bharathi D R
Keyword(s):  
Illness Perceptions ◽  
Pharmacist Intervention ◽  
Cross Sectional Study ◽  
Chronic Obstructive ◽  
Cross Sectional ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients ◽  
Post Test ◽  
Knowledge Practice ◽  
And Control

Background: Chronic obstructive pulmonary disease (COPD) is preventable and treatable disease state characterized by air flow limitation that is not fully reversible. Severity of the symptoms is increased during exacerbations. Objectives: The purpose of the study is to assess and improve the knowledge regarding COPD among study subjects. Materials and Methods: A Cross-sectional interventional study was carried out among the peoples in selected areas of the Chitradurga city for a period of six months. Result: A total 207 subjects enrolled in the study in that 155 male and 52 females. In our study mean score of post test was more (5.87±1.68) when compare to pre-test (2.63±1.46) which show significant increase in their knowledge after educating them (p=0.000). A total of 207 subjects were enrolled into the study. SPSS Software was used to calculate the statistical estimation. Paired t-test was used to detect the association status of different variables. Conclusion: The relatively good level of COPD awareness needs to be maintained to facilitate future prevention and control of the disease. This study had identified that negative illness perceptions should be targeted, so that they will not avoid patients from seeking for COPD treatment and adhere to it. Key words: Cross sectional study, Knowledge, practice, COPD.

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