Prevalence and risk factors for latent tuberculosis infection among household contacts of index cases in two South African provinces: Analysis of baseline data from a cluster-randomised trial

IntroductionIndia has the largest burden of cases and deaths related to tuberculosis (TB). Undernutrition is the leading risk factor accounting for TB incidence, while severe undernutrition is a common risk factor for mortality in patients with TB in India. The impact of nutritional supplementation on TB incidence is unknown, while few underpowered studies have assessed its impact on TB mortality. We designed an open-label, field-based cluster randomised trial to assess the impact of nutritional supplementation (with food rations) on TB incidence in a group at higher risk of TB infection and disease, viz household contacts (HHC) of patients with microbiologically confirmed pulmonary TB (PTB) in Jharkhand, a state with a high prevalence of undernutrition.Methods and analysisWe shall enrol 2800 adult patients with PTB of the national TB programme, across 28 treatment units in 4 districts, and their approximately 11 200 eligible contacts. The sample size has 80% power to detect the primary outcome of 50% reduction in incidence of active TB in HHC over 2 years of follow-up. Patients and HHC in both the arms will undergo nutritional assessment and counselling. Patients will receive monthly food rations (supplying 1200 kcal and 52 g proteins/day) and multivitamins along with antitubercular treatment. The HHC in the intervention arm will receive food rations (supplying 750 kcal and 23 g proteins/day) and multivitamins while HHC in control arm will be on usual diet. The secondary outcomes in HHC will include effects on nutritional status, non-TB infections. Secondary outcomes in patients are effects on TB mortality, adherence, adverse effects, nutritional and performance status. Substudies will examine micronutrient status and effects on dietary intake, body composition, muscle strength and immune function.Ethics and disseminationThe institutional ethics committee of ICMR-NIRT, Chennai, approved the study (289/NIRT-IEC/2018). The results will be disseminated in publications and presentations.Trial registration numberClinical Trial Registry of India: CTRI/2019/08/020490.

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Prevalence of latent tuberculosis infection and its risk factors in Japanese hemodialysis patients

Clinical and Experimental Nephrology ◽

10.1007/s10157-021-02093-w ◽

2021 ◽

Author(s):

Yohei Ogawa ◽

Makoto Harada ◽

Koji Hashimoto ◽

Yuji Kamijo

Keyword(s):

Risk Factors ◽

Latent Tuberculosis Infection ◽

Latent Tuberculosis ◽

Hemodialysis Patients ◽

Tuberculosis Infection

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P3.380 Baseline Results of a Cluster-Randomised Trial Assessing the Effectiveness of Sport-Based HIV Prevention in South African Schools

Sexually Transmitted Infections ◽

10.1136/sextrans-2013-051184.0833 ◽

2013 ◽

Vol 89 (Suppl 1) ◽

pp. A268.1-A268

Author(s):

Z A Kaufman ◽

E B Kaufman ◽

S Dringus ◽

H A Weiss ◽

S Delany-Moretlwe ◽

...

Keyword(s):

Hiv Prevention ◽

South African ◽

Randomised Trial ◽

Cluster Randomised Trial ◽

Cluster Randomised

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Prevalence of latent tuberculosis infection and associated risk factors in prison in East Wollega Zone of western Ethiopia

PLoS ONE ◽

10.1371/journal.pone.0233314 ◽

2020 ◽

Vol 15 (5) ◽

pp. e0233314

Author(s):

Basha Chekesa ◽

Balako Gumi ◽

Mahlet Chanyalew ◽

Aboma Zewude ◽

Gobena Ameni

Keyword(s):

Risk Factors ◽

Latent Tuberculosis Infection ◽

Latent Tuberculosis ◽

Tuberculosis Infection ◽

Associated Risk Factors ◽

Western Ethiopia

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754. Prevalence of Latent Tuberculosis Infection Among Healthcare Workers at a Tertiary Care University Hospital

Open Forum Infectious Diseases ◽

10.1093/ofid/ofy210.761 ◽

2018 ◽

Vol 5 (suppl_1) ◽

pp. S271-S271

Author(s):

Eun Ju Choo ◽

Se Yoon Park

Keyword(s):

Risk Factors ◽

Healthcare Workers ◽

Latent Tuberculosis Infection ◽

Tertiary Care ◽

Latent Tuberculosis ◽

Tuberculosis Infection ◽

University Hospital ◽

Increased Risk ◽

High Prevalence ◽

Univariate Analyses

Abstract Background We investigated the prevalence of latent tuberculosis infection (LTBI) among healthcare workers (HCWs) and analyzed its risk factors in a tertiary care university hospital in South Korea in a population with intermediate tuberculosis (TB) burden. Methods A standard questionnaire regarding the baseline demographics and risk factors for LTBI was given to each participant. QuantiFERON-TB GOLD In-Tube (QFT-GIT) assay and chest radiography were performed to investigate the rate of LTBI. Results A total of 1,429 participants, 213 (14.9%) doctors and 988 (69.1%) nurses and 228 (16.0%) others were enrolled. The mean age of the subjects was 33.0 years old, and 1,175 (82.2%) were female. Of the participants, 94.5% had received BCG vaccine. QFT-GIT assays were positive for 156 subjects (10.9%). Of the 213 doctors, 28 (13.1%) were positive by QFT-GIT, and among the 988 nurses, 94 (9.5%) had positive QFT-GIT results. Experience of working in hospital was significantly associated with positive LTBI test results by QFT-GIT assay. Gender and duration of employment as an HCW were significantly associated with having a positive QFT-GIT result in univariate analyses. In multivariate analyses, duration of employment as an HCW (>15 years) (odds ratio, 1.98; 95% confidence interval, 1.14–3.43) was independently associated with increased risk of a positive QFT-GIT result. Conclusion A high prevalence of LTBI was found among our HCWs. Considering the association between the experience of working in hospital and high risk of LTBI. The risk for tuberculosis infection among HCWs was higher than general population, which suggests that stricter preventive strategies against nosocomial tuberculosis infection should be implemented. Disclosures All authors: No reported disclosures.

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Predictors of discordant latent tuberculosis infection test results amongst South African health care workers

BMC Infectious Diseases ◽

10.1186/s12879-019-3745-5 ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 4

Author(s):

Shahieda Adams ◽

Rodney Ehrlich ◽

Roslynn Baatjies ◽

Nandini Dendukuri ◽

Zhuoyu Wang ◽

...

Keyword(s):

Health Care ◽

South African ◽

Health Care Workers ◽

Latent Tuberculosis Infection ◽

Latent Tuberculosis ◽

Tuberculosis Infection ◽

Test Results ◽

African Health ◽

Care Workers ◽

South African Health

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Incidence of occupational latent tuberculosis infection in South African healthcare workers

European Respiratory Journal ◽

10.1183/09031936.00138414 ◽

2015 ◽

Vol 45 (5) ◽

pp. 1364-1373 ◽

Cited By ~ 27

Author(s):

Shahieda Adams ◽

Rodney Ehrlich ◽

Roslynn Baatjies ◽

Richard N. van Zyl-Smit ◽

Qonita Said-Hartley ◽

...

Keyword(s):

South African ◽

Conversion Rate ◽

Healthcare Workers ◽

Latent Tuberculosis Infection ◽

Latent Tuberculosis ◽

Control Measures ◽

Sub Saharan Africa ◽

Tuberculosis Infection ◽

Healthcare Sector ◽

Conversion Rates

The test-specific incidence of latent tuberculosis infection (LTBI) in healthcare workers from sub-Saharan Africa is unknown.505 healthcare workers from South Africa were screened at baseline, and after 12 months, with a questionnaire, the tuberculin skin test (TST), and two T-cell assays (T-SPOT.TB and QuantiFERON-TB Gold-In-Tube). Test-specific conversion rates were calculated.The prevalence of presumed LTBI at baseline was 84, 69 and 62% using the TST, QuantiFERON-TB Gold-In-Tube and T-SPOT.TB, respectively. The annual test-specific conversion rate, depending on the cut-off point used, was as follows: TST 38%; QuantiFERON-TB Gold-In-Tube 13–22%; and T-SPOT.TB 18–22%. Annual reversion rates were 4, 7 and 16%, respectively. The annual TST conversion rate was significantly higher than that derived from published local community-based data (IRR 3.53, 95% CI 1.81–6.88). Factors associated with conversion (any test) included healthcare sector of employment, counselling of tuberculosis patients, and a baseline positive TST (for T-SPOT.TB).The annual rate of tuberculosis infection in South African healthcare workers was very high, irrespective of the testing method used, and may be explained by occupational exposure, as the rate was considerably higher than non-healthcare workers from the same community. Collectively, these data support the need for implementation of tuberculosis-specific infection control measures in Africa.

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