Abstract
BackgroundNo established strategy for household tuberculosis (TB) contact investigation (HTCI) exists in Ethiopia. We implemented integrated, active HTCI model into two hospitals and surrounding community health services to determine yield of active HTCI of all forms of TB and explore factors associated with active TB diagnosis in household contacts (HHCs).MethodsCase managers obtained HHC information from index cases at TB/DOTS clinic and liaised with health extension workers (HEWs) who screened HHCs for TB at household and referred contacts under five and presumptive cases for diagnostic investigation.ResultsFrom 363 all forms TB index cases, 1509 (99%) HHCs were screened and 809 (54%) referred, yielding 19 (1.3%) all forms TB cases. HTCI of sputum smear-positive pulmonary TB (SS + PTB) index cases produced yield of 4.3%. HHCs with active TB were more likely to be malnourished (OR: 3.39, 95%CI: 1.19–9.64), live in households with SS + PTB index case (OR: 7.43, 95%CI: 1.64–33.73) or TB history (OR: 4.18, 95%CI: 1.51–11.55).ConclusionActive HTCI of all forms of TB cases produced comparable or higher yield than reported elsewhere. HTCI contributes to improved and timely case detection of Tuberculosis among population who may not seek health care due to minimal symptoms or access issues. Active HTCI can successfully be implemented through integrated approach with existing community TB programs for better coordination and efficiency. Referral criteria should include factors significantly associated with active disease.
Highlights
No established strategy for household tuberculosis (TB) contact investigation (HTCI) exists in Ethiopia
This paper presents results from a study of active HTCI integrated into routine facility- and community-based TB services in northern Ethiopia
We explored factors associated with active TB among Household contacts (HHC) using a multivariate generalized estimating equation (GEE) model composed of known active TB [8] risk factors found significant at p < 0.1 in TB Clinic: TB clinic staff
Summary
No established strategy for household tuberculosis (TB) contact investigation (HTCI) exists in Ethiopia. Lack of routine access to better diagnostics such as Xpert MTB/RIF and culture as well as quality control contribute to low detection rates [1,2,3,4]. The yield of new active TB cases is greater among household contacts (HHCs) than the general population [12, 13]. Recent meta-analyses of household TB contact investigation (HTCI) in low- and middle-income countries revealed a prevalence of 3.1% all forms TB [12] and 1.5% bacteriologically confirmed TB [14] among HHCs. implementation in low-income countries remains limited with significant heterogeneity in policies, procedures, and results [12–
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
