Assistance of health cadres to improve the ability of tuberculosis contact investigation

2021 ◽  
Vol 6 (11) ◽  
pp. 2041-2047
Author(s):  
Dafrosia Darmi Manggasa ◽  
Dewi Nurviana Suharto ◽  
Raden Bagus Bambang Hermanto ◽  
Ni Nyoman Aldina
Keyword(s):  
Contact Investigation

Indonesia menempati urutan kedua dengan jumlah Tuberkulosis (TBC) terbanyak didunia. Investigasi kontak merupakan salah satu strategi eliminasi TBC yang dapat dilakukan oleh kader kesehatan namun kader belum mampu melakukan investigasi kontak TBC di masyarakat. Tujuan kegiatan pengabdian masyarakat ini untuk meningkatkan kemampuan kader dalam melakukan investigasi kontak TBC. Metode pengabdian yaitu kegiatan pendampingan berupa orientasi, simulasi dan praktek. Hasil kegiatan ini dapat meningkatkan pengetahuan dan keterampilan kader kesehatan dalam melakukan investigasi kontak TBC sehingga kader memiliki kemampuan dan dapat berperan aktif dalam melakukan investigasi kontak untuk penemuan terduga TBC secara dini.

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

Role of digital tomosynthesis in the context of tuberculosis contact investigation: comparisons with digital radiography

2021 ◽  
pp. 028418512110224
Author(s):  
Jeongha Mok ◽  
Jeong A Yeom ◽  
Su Won Nam ◽  
Jun Mi Yoo ◽  
Ji Won Lee ◽  
...  
Keyword(s):  
Digital Radiography ◽  
Low Dose ◽  
Close Contact ◽  
Correct Diagnosis ◽  
Lower Sensitivity ◽  
Digital Tomosynthesis ◽  
Reference Standard ◽  
Contact Investigation ◽  
Screening Study ◽  
Low Dose Computed Tomography

Background Chest radiography value as a screening tool in those exposed to pulmonary tuberculosis (TB) is reduced by its lower sensitivity to detect small intrapulmonary lesions. Purpose To evaluate the efficacy of digital tomosynthesis (DTS) screening of individuals that had contacted persons with active TB using low-dose computed tomography (CT) as the reference standard methods. Material and Methods This retrospective, community-based screening study of 90 adults who had been in close contact with a TB case was undertaken at our institution. All individuals underwent clinical evaluation, digital radiography (DR), DTS, and low-dose chest CT. Observers assessed and classified DR and DTS images using CT as the reference-standard method. Based on clinical and imaging findings, TB status was classified as normal, latent, minimal, subclinical, and active. Diagnostic performances of DTS and DR for the interpretation of correct diagnosis were calculated. Results The estimated effective doses for DR, DTS, and low-dose CT were 0.01 mSv, 0.1 mSv, and 0.33 mSv, respectively. TB statuses of the 90 individuals were as follows: 62 latent (68.9%); two subclinical (2.2%); and one minimal (1.1%). The sensitivities, specificities, and accuracies of DTS and DR in the interpretation of correct diagnosis were 75.8%, 100%, 91.1% and 48.5%, 96.5%, 78.9%, respectively. Conclusion DTS appears to be superior to DR for the detection of lung lesions in individuals with TB contacts. DTS can offer a reasonable option for TB contact investigation.

scholarly journals 806. 2013–2015 Nationwide Tuberculosis Contact Investigation in Childcare Centers and Schools in Korea

2018 ◽  
Vol 5 (suppl_1) ◽  
pp. S289-S289
Author(s):  
Woosuck Suh ◽  
Jong-Hyun Kim ◽  
Ji Hyen Hwang ◽  
Sodam Lee ◽  
Kang-Hee Lee ◽  
...  
Keyword(s):  
School Setting ◽  
Age Groups ◽  
Disease Status ◽  
Childcare Centers ◽  
X Ray ◽  
Contact Investigation ◽  
Chest X Ray ◽  
Latent Tb ◽  
The Republic ◽  
Latent Tb Infection

Abstract Background The Republic of Korea has the highest incidence rate of tuberculosis (TB) among members of the OECD, reported as 78.8/100,000 population in 2016. In response, a state-run intensive contact investigation for TB is being conducted. More effective TB control requires an epidemiologic emphasis on the diagnosis and treatment of latent TB infections in children and adolescents, compared with other age groups. Here we present an analysis of data from the childcare center and school contact investigation by the Korea Centers for Disease Control and Prevention (CDC) in 2013–2015. Methods Data collected from index patients included age, sex, occupation, disease status, results of AFB smear/culture, and chest x-ray. Data collected from contacts included age, sex, results of serial tuberculin skin test (TST), and chest x-ray. Congregate settings included childcare centers, kindergartens, elementary and secondary schools, and age groups were stratified as follows: 0–4 years, 5–12 years, and 13–18 years. TSTs were considered positive if induration ≥10 mm on the first test (TST1) or demonstrated an increase ≥6 mm over the induration of TST1 on repeat testing after 8 weeks (TST2). Results Of the 197,801 subjects with data collected, 173,998 were eligible and included in our analysis. TST1 results were available for 159,346 (91.6%) and when results were positive, induration was 10–14 mm in 7.6% and ≥15 mm in 1.5%. TST2 results were available for 119,797 (82.7%) of the 144,904 with negative TST1, and conversion rate was 9.0%. Altogether considering TST1 and TST2, 17.3% contacts had latent TB infections. Positive rates of TST significantly decreased with age: 20.3% in 0–4 years, 18.8% in 5–12 years, 17.1% in 13–18 years. Conclusion In this 3-year school-setting contact investigation, 17.3% contacts were diagnosed with latent TB infection, as demonstrated by TST reactions. Positive rates of TST significantly but mildly decreased with age. Disclosures All authors: No reported disclosures.

Tuberculosis contact investigation in a high-burden setting: house or household?

2012 ◽  
Vol 16 (2) ◽  
pp. 157-162 ◽  
Author(s):  
S. S. Van Wyk ◽  
A. M. Mandalakas ◽  
D. A. Enarson ◽  
R. P. Gie ◽  
N. Beyers ◽  
...  
Keyword(s):  
High Burden ◽  
Contact Investigation

scholarly journals Community intervention for child tuberculosis active contact investigation and management: study protocol for a parallel cluster randomized controlled trial

Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Anca Vasiliu ◽  
Sabrina Eymard-Duvernay ◽  
Boris Tchounga ◽  
Daniel Atwine ◽  
Elisabete de Carvalho ◽  
...  
Keyword(s):  
Controlled Trial ◽  
Standard Of Care ◽  
Preventive Therapy ◽  
Community Based ◽  
Randomized Controlled ◽  
Eligible Child ◽  
Contact Investigation ◽  
Cluster Randomized ◽  
The Impact ◽  
Index Cases

Abstract Background There are major gaps in the management of pediatric tuberculosis (TB) contact investigation for rapid identification of active tuberculosis and initiation of preventive therapy. This study aims to evaluate the impact of a community-based intervention as compared to facility-based model for the management of children in contact with bacteriologically confirmed pulmonary TB adults in low-resource high-burden settings. Methods/design This multicenter parallel open-label cluster randomized controlled trial is composed of three phases: I, baseline phase in which retrospective data are collected, quality of data recording in facility registers is checked, and expected acceptability and feasibility of the intervention is assessed; II, intervention phase with enrolment of index cases and contact cases in either facility- or community-based models; and III, explanatory phase including endpoint data analysis, cost-effectiveness analysis, and post-intervention acceptability assessment by healthcare providers and beneficiaries. The study uses both quantitative and qualitative analysis methods. The community-based intervention includes identification and screening of all household contacts, referral of contacts with TB-suggestive symptoms to the facility for investigation, and household initiation of preventive therapy with follow-up of eligible child contacts by community healthcare workers, i.e., all young (< 5 years) child contacts or older (5–14 years) child contacts living with HIV, and with no evidence of TB disease. Twenty clusters representing TB diagnostic and treatment facilities with their catchment areas are randomized in a 1:1 ratio to either the community-based intervention arm or the facility-based standard of care arm in Cameroon and Uganda. Randomization was stratified by country and constrained on the number of index cases per cluster. The primary endpoint is the proportion of eligible child contacts who initiate and complete the preventive therapy. The sample size is of 1500 child contacts to identify a 10% difference between the arms with the assumption that 60% of children will complete the preventive therapy in the standard of care arm. Discussion This study will provide evidence of the impact of a community-based intervention on household child contact screening and management of TB preventive therapy in order to improve care and prevention of childhood TB in low-resource high-burden settings. Trial registration ClinicalTrials.gov NCT03832023. Registered on 6 February 2019

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