Prevalence of latent TB infection among childhood contacts of adults with sputum positive pulmonary TB

Abstract

BackgroundTuberculosis is a global public health challenge. More stringent activities are needed for evaluation of ongoing TB transmission. The study was aimed at estimating the prevalence of LTBI in children below 15 years who are household contacts of adults with sputum positive pulmonary TB and identify the determinants involved in TB transmission. The compliance and incidence of adverse events were also studied. MethodologyAn observational study was conducted among 194 children below 15 years who were in contact with 145 adults with smear positive pulmonary TB. All children below 5 years underwent TST and were offered LTBI chemoprophylaxis as per NTEP program while IGRA was used to diagnose LTBI in children above 5 years. A structured questionnaire was used to collect data on determinants of TB transmission. Children were followed up during the LTBI treatment period for assessing compliance and the adverse effects. ResultsThe prevalence of LTBI among the study participants was 15.4 %. Children who received LTBI treatment showed good acceptance with a drug compliance of 98.5 % and only 21 % showed adverse events, all of which were minor. Malnutrition (p value-0.03), overcrowding (P value = 0.014) and exposure to tobacco smoke (p value = 0.000) were identified as the socio-demographic determinants affecting TB transmission. ConclusionChildren below 15 years are at high risk of contracting TB from household adult contacts. Overcrowding, malnutrition and exposure to tobacco smoke being the determinants of TB transmission, screening programmes should prioritise children exposed to such situations, especially in resource limited settings like India.