Household Contacts Research Articles

Severe Acute Respiratory Syndrome Coronavirus 2 Household Transmission During the Omicron Era in Massachusetts: A Prospective, Case-Ascertained Study Using Genomic Epidemiology.

Households are a major setting for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections, but there remains a lack of knowledge regarding the dynamics of viral transmission, particularly in the setting of preexisting SARS-CoV-2 immunity and evolving variants. We conducted a prospective, case-ascertained household transmission study in the greater Boston area in March-July 2022. Anterior nasal swabs, along with clinical and demographic data, were collected for 14 days. Nasal swabs were tested for SARS-CoV-2 by polymerase chain reaction (PCR). Whole genome sequencing was performed on high-titer samples. We enrolled 33 households in a primary analysis set, with a median participant age of 25 years (range, 2-66 years), 98% of whom had received at least 2 doses of a coronavirus disease 2019 (COVID-19) vaccine. Fifty-eight percent of households had a secondary case during follow-up and the secondary attack rate (SAR) for contacts was 39%. We further examined a strict analysis set of 21 households that had only 1 PCR-positive case at baseline, finding an SAR of 22.5%. Genomic epidemiology further determined that there were multiple sources of infection for household contacts, including the index case and outside introductions. When limiting estimates to only highly probable transmissions given epidemiologic and genomic data, the SAR was 18.4%. Household contacts of a person newly diagnosed with COVID-19 are at high risk for SARS-CoV-2 infection in the following 2 weeks. This is, however, not only due to infection from the household index case, but also because the presence of an infected household member implies increased SARS-CoV-2 community transmission.

Assessing infectiousness and the impact of effective treatment to guide isolation recommendations for people with pulmonary tuberculosis.

Determining the extent and duration of infectiousness of individuals with pulmonary tuberculosis (TB) is critical for various aspects of TB care, including decisions regarding isolation. Studies suggest considerable heterogeneity in infectiousness of people with pulmonary TB. Pre-treatment, measures of bacillary burden including sputum smear microscopy, culture time-to-positivity, and Xpert MTB/RIF cycle threshold (Ct) value, predict the risk of transmission to contacts. Index patients with smear negative disease pose lower infectious risk than those who have smear-positive disease, and household contact infection is more likely with index patients who have lower Xpert Ct values. Newer tools that enable detection of Mycobacterium tuberculosis complex (Mtb complex) from cough aerosol sampling and face mask sampling may be better predictors of contact infection risk. Clinical factors such as cough strength and frequency, and presence of cavitation on chest imaging, may also assist with risk prediction. Post-treatment, smear and culture status are poor predictors of infectiousness. While the exact duration of infectiousness post treatment initiation remains uncertain, data from human-to-guinea pig transmission studies and clinical studies suggest effective treatment results in a rapid decline in infectiousness, irrespective of smear or culture conversion. This is largely supported by early bactericidal activity and transcriptomic studies, and cough aerosol sampling studies, although a subset of patients may have persistent cough aerosol positivity. These findings can enable a more nuanced approach to isolation decision making, while further research studies are awaited.

Profile of Leprosy Patients at the Dermatology and Venereology Polyclinic of Dr. M. Djamil Padang Hospital in 2018-2021

Leprosy is a chronic infectious disease caused by Mycobacterium leprae that attacks several parts of the body, especially the upper respiratory tract, skin, and peripheral nerves. Indonesia is the third country with the most leprosy in the world. This study aims to determine the profile of leprosy patients at the Dermatology and Venereology Polyclinic Dr. M. Djamil Padang Hospital in 2018-2021. This research is descriptive retrospective with total sampling technique using secondary data in the form of medical records. The sample of this study were all leprosy patients in 2018-2021 who were fulfilled inclusion criteria, with a total of 39 patients. The results showed that the most age group was >14 years (100%), the most gender was male (74.36%), the most residence was Padang (33.33%), and almost all leprosy patients (92.31%) had no history of household contact with leprosy patients. Most of the leprosy patients were of the multibacillary type (74.36%) with positive smear results (46.15%), without leprosy reaction (61.54%), and the most disability level that occurred was grade 0 disability (48.72%). The conclusion of this study is that most cases of leprosy at the Dermatology and Venereology Polyclinic RSUP Dr. M. Djamil Padang in 2018-2021 aged >14 years, male, having address in Padang City, had no history household contact, multibacillary type, positive smear result, without reaction, and level 0 disability.

Quantifying age-specific household contacts in Aotearoa New Zealand for infectious disease modelling.

Accounting for population age structure and age-specific contact patterns is crucial for accurate modelling of human infectious disease dynamics and impact. A common approach is to use contact matrices, which estimate the number of contacts between individuals of different ages. These contact matrices are frequently based on data collected from populations with very different demographic and socio-economic characteristics from the population of interest. Here we use a comprehensive household composition dataset based on Aotearoa New Zealand census and administrative data to construct a household contact matrix and a synthetic population that can be used for modelling. We investigate the behaviour of a compartment-based and an agent-based epidemic model parametrized using these data, compared with a commonly used contact matrix that was constructed by projecting international data onto New Zealand's population. We find that using the New Zealand household data, either in a compartment-based model or in an agent-based model, leads to lower attack rates in older age groups compared with using the projected contact matrix. This difference becomes larger when household transmission is more dominant relative to non-household transmission. We provide electronic versions of the synthetic population and household contact matrix for other researchers to use in infectious disease models.

Within-household SARS-CoV-2 transmission and vaccine effectiveness in the first three COVID-19 school outbreaks in northern Viet Nam, September-December 2021.

The risk of transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) from schoolchildren to their household and the protective effects of vaccination in these settings remain poorly understood. We assessed the transmission dynamics of schoolchildren with SARS-CoV-2 within their households and the protective effects of coronavirus disease (COVID-19) vaccination among household members in Viet Nam. We estimated the attack rate, vaccine effectiveness and adjusted risk ratio (aRR) of factors associated with SARS-CoV-2 transmission to household contacts of children confirmed to have COVID-19 who attended three schools in Ha Nam, Phu Tho and Thanh Hoa provinces between September and December 2021 using multivariable regression with household-level random effects. This retrospective cohort study included 157 children infected with SARS-CoV-2 and their 540 household contacts. The attack rate among household contacts was 24.6% (133/540). Overall, vaccine effectiveness among household contacts was 39% (95% confidence interval [CI]: -1 to -63), higher among males than females and higher in adults aged >40 years. COVID-19 transmission was greater among female household contacts compared with males (aRR: 1.35, 95% CI: 0.94 to 1.95), although not statistically significant, and highest among those aged 19-39 years (aRR: 2.51, 95% CI: 1.50 to 4.21). Fully vaccinated household contacts had significantly lower infection risk (aRR: 0.46, 95% CI: 0.26 to 0.84). We found substantial onward transmission of SARS-CoV-2 from schoolchildren to household members, and older people were more likely to be protected by vaccination. We recommend that schoolchildren and all household members living with schoolchildren receive at least two doses of a COVID-19 vaccine. Recognizing the role of schoolchildren in the onward transmission of COVID-19 is an important lesson learned by Viet Nam that can help not only in managing other outbreaks but also in protecting schoolchildren by predicting the progress of the outbreak and preparing for a timely response.

Prevalence, duration, and factors influencing post-COVID conditions among patients at several public hospitals, Alexandria governorate, Egypt 2022–2023

BackgroundPost-COVID conditions (PCC), characterized by persistent symptoms following acute infection, represent an emerging chronic illness that potentially affects millions of people worldwide. SARS-CoV-2 infection has resulted in a PCC incidence ranging from 10 to 30 % in non-hospitalized individuals to 50–70 % in hospitalized patients. Most PCC patients experience mild symptoms, while a minority report severe manifestations. We aimed to estimate the prevalence of PCC among COVID-19 patients who attended three public hospitals in Alexandria, Egypt between June 2022 and February 2023, and to investigate its risk factors. MethodsAll COVID-19-confirmed patients aged >18 years attended the selected hospitals, and their household contacts were contacted. Data were collected through telephone interviews using a questionnaire adapted from World Health Organization (WHO) and Penn Medicine tools, covering demographics, COVID-19 history, and PCC symptoms. PCC was defined as symptoms starting three months after the post-acute infection and lasting for at least two months beyond. Statistical analyses employed descriptive statistics, chi-square tests, and a logistic regression model, with a significance level of p < 0.05. ResultsA total of 1546 patients were enrolled. Their mean age was 39.7 ± 15.9 years, 46.0 % were males, and 13.9 % had comorbidities. Of them, 760 patients (49.2 %) reported PCC symptoms including, 52.6 % seen at outpatients, 26.7 % were admitted, and 0.5 % required admission to ICU. PCC symptoms included shortness of breath (94.2 %), mood changes (13.9 %), cough (13.0 %), and fatigue (8.8 %). PCC was associated with older age, hospitalization during acute COVID-19, comorbidities including asthma, hypertension, and diabetes, as well as treatment with different COVID-19 medications. Logistic regression shows that asthma, male gender, and treatment with medicines at the hospital remained significant in the model (ORs: 6.85, 0.36, and 0.88, p < 0.001). ConclusionThis study sheds light on PCC's prevalence and influencing factors following infection in Alexandria, Egypt. Common PCC symptoms included difficulty in breathing, fatigue, and psychological manifestations. The findings emphasize the critical need for early intervention and targeted management strategies, especially for high-risk groups such as asthma patients, to alleviate the long-term health consequences of COVID-19. Study results could guide the prevention of PCC e.g., through vaccination, management of long-term sequelae of PCC e.g., rehabilitation, and psychological support initiatives.

An Investigation of a Community Chickenpox Outbreak with a Fatal Case, Songkhla Province, Thailand, October 2022

In October 2022, a suspected chickenpox death was notified. A field investigation was done to verify the diagnosis and cause of death, describe the epidemiological characteristics, identify risk factors, and control the outbreak. We conducted a descriptive study and a matched case-control study. A case was defined as a person with multiple stages of skin lesions on at least two body areas in Subdistrict from 1 Aug 2022 to 24 Oct 2022. We reviewed medical records and searched for cases house-to-house. For the matched case-control study, cases were chickenpox cases residing in Bo Tru Subdistrict, from 1 Aug 2022 to 14 Oct 2022. Controls were neighbors without symptoms or chickenpox history, matched by age. Samples were tested using the reverse transcription polymerase chain reaction technique. Environmental surveys were performed. We identified 30 cases including the deceased, who was 49 years old. The median (interquartile range) age of the cases was 11 (7–38) years. Seventeen were elementary-school students. None of the cases received chickenpox vaccination or had a history of chickenpox. The secondary attack rate among household contacts was 41.2% (14/34). Reverse transcriptase polymerase chain reaction tests from three cases were all positive. Being a close contact with a case and sharing personal utensils were risk factors. We strengthened the surveillance system for early detection and treatment and provided risk communication in the community. Chickenpox cases should be isolated from susceptible persons. Standard treatment guidelines for complicated cases should be distributed among healthcare services.

Assessment of Long-Term Changes in Knowledge and Attitudes of Household Contacts of COVID-19 Cases in Northern Spain.

This study aims to describe the long-term changes in the knowledge of, and attitudes towards, COVID-19 and its preventive measures in northern Spain. A telephonic survey was performed among household contacts of COVID-19 cases in Catalonia and Navarre between May 2022 and December 2023. Knowledge and attitudes were assessed through 12 questions using a Likert scale, and responses were grouped as correct or incorrect. The change from baseline to the 6-month follow-up was evaluated with the absolute difference (AD) using the proportion of correct answers. At baseline, 299 subjects were contacted, of whom 63.2% (189) completed the 6-month follow-up. Correct knowledge of transmission (>85%) and the use of preventive measures (>92%) were observed at baseline and maintained over time. The attitudes towards face mask use remained adequate over the course of six months (>79%). However, attitudes regarding the use of face masks indoors (AD = -16.4%; p < 0.001) and those who thought that COVID-19 had a negative impact on their lives (AD = -16.5%; p < 0.001) decreased after 6 months. In the post-acute phase of the pandemic, household contacts maintained the correct level of knowledge towards COVID-19, while some attitudes decreased. These results should serve as a guide for health policy makers in decision-making in case of a new increase in the incidence of SARS-CoV-2.

Test and treat approach for tuberculosis infection amongst household contacts of drug-susceptible pulmonary tuberculosis, Mumbai, India.

Mumbai is one of the most densely populated areas in the world and is a major contributor to the tuberculosis (TB) epidemic in India. A test and treat approach for TB infection (TBI) amongst household contacts (HHC) is part of the national policy for TB preventive treatment (TPT). However, in practice, the use of interferon-gamma release assay (IGRA) tests for infection are limited, and prevalence of TBI in Mumbai is not known. We conducted a cross-sectional study among HHCs exposed to persons with microbiologically-confirmed, drug-susceptible pulmonary TB that were notified for antituberculosis treatment in Mumbai, India during September-December, 2021. Community-based field workers made home visits and offered IGRA (QuantiFERON-TB® Gold In-Tube Plus) tests to HHC aged 5 years and older. After ruling out active TB disease, HHC with IGRA-positive test results were referred for TPT. All HHC were monitored for at least 24 months for progression to active TB disease. Among 502 HHCs tested, 273 (54%) had IGRA-positive results. A total of 254 (93%) were classified as TBI and were eligible for TPT, of which 215 (85%) initiated TPT, and 194 (90%) completed TPT successfully. There was substantial variation in rates of TBI per household. In 32% of households, all HHC (100%) were IGRA positive and in 64% of households >50% of HHC were infected. In all, 22 HHCs (4%; 22/558) were diagnosed with TB disease; of these, five HHC were diagnosed during follow up, of which three were IGRA positive and had no evidence of disease at initial screening but chose not to initiate TPT. A test and treat strategy for HHC resulted in the detection of a substantial proportion of TBI and secondary TB cases. Home-based IGRA testing led to high participation rates, clinical evaluations, TPT initiation, and early diagnoses of additional secondary cases. A community-focused, test and treat approach was feasible in this population and could be considered for broader implementation.

Population Pharmacokinetics of Casirivimab and Imdevimab in Pediatric and Adult Non-Infected Individuals, Pediatric and Adult Ambulatory or Hospitalized Patients or Household Contacts of Patients Infected with SARS-COV-2

IntroductionCasirivimab (CAS) and imdevimab (IMD) are two fully human monoclonal antibodies that bind different epitopes on the receptor binding domain of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and block host receptor interactions. CAS + IMD and was developed for the treatment and prevention of SARS-CoV-2 infections.MethodsA population pharmacokinetic (PopPK) analysis was conducted using pooled data from 7598 individuals from seven clinical studies to simultaneously fit concentration–time data of CAS and IMD and investigate selected covariates as sources of variability in PK parameters. The dataset comprised CAS + IMD-treated pediatric and adult non-infected individuals, ambulatory or hospitalized patients infected with SARS-CoV-2, or household contacts of patients infected with SARS-CoV-2.ResultsCAS and IMD concentration–time data were both appropriately described simultaneously by a two-compartment model with first-order absorption following subcutaneous dose administration and first-order elimination. Clearance estimates of CAS and IMD were 0.193 and 0.236 L/day, respectively. Central volume of distribution estimates were 3.92 and 3.82 L, respectively. Among the covariates identified as significant, body weight and serum albumin had the largest impact (20–34%, and ~ 7–31% change in exposures at extremes, respectively), while all other covariates resulted in small differences in exposures. Application of the PopPK model included simulations to support dose recommendations in pediatrics based on comparable exposures of CAS and IMD between different weight groups in pediatrics and adults following weight-based dosing regimens.ConclusionsThis analysis provided important insights to characterize CAS and IMD PK simultaneously in a diverse patient population and informed pediatric dose selection.

Relevance of antigen-induced IL-6 and mitogen-induced or spontaneous IFN-γ secretions in whole blood cultures for detection of Mycobacterium tuberculosis infection and disease.

For an effective control of tuberculosis (TB), there is a persistent need for biomarkers that can report true estimates of TB infection (TBI) and predict its progression towards active TB disease. We investigated whether the cell-mediated immune responses to Mycobacterium tuberculosis (Mtb) antigens could provide such biomarkers. The study subjects (n = 174) comprised a cohort of smear-positive, drug-sensitive, HIV-negative pulmonary TB patients (n = 54) and their household contacts (HC, n = 120). Whole blood cultures, in the presence or absence of Mtb antigens- membrane (MtM), purified protein derivative (PPD) and alpha-crystallin (Acr), or the mitogen PHA were subjected to determinations, by flow cytometry, for T cell proliferative and, by ELISA, for IFN-γ, TNF-α, and IL-6 cytokine responses. Additionally, serum levels of the three cytokines were also estimated. The strongest cell-proliferative and cytokine responses were induced by MtM and IL-6 was the most abundantly produced cytokine. While none of the responses induced by Mtb antigens or the serum cytokines levels could discriminate between TB and HC, the exvivo cytokine responses induced by PHA or 'spontaneously' could apparently do so. The concentrations of IFN-γ induced by PHA in TB blood cultures were significantly lower than in HC cultures (AUC = 0.72). Conversely, the spontaneous IFN-γ or TNF-α secretions in TB cultures were significantly higher than in HC cultures (AUC = 0.66). Our results suggest that IL-6 responses to MtM could be a sensitive indicator of TBI, and low levels of PHA-induced or high levels of spontaneous IFN-γ secretions in HC blood cultures may indicate a progressive infection.

HIV, malnutrition, and noncommunicable disease epidemics among tuberculosis-affected households in east and southern Africa: A cross-sectional analysis of the ERASE-TB cohort.

As a result of shared social and structural risk factors, people in households affected by tuberculosis may have an increased risk of chronic conditions; at the same time, tuberculosis screening may be an opportunity for interventions. We sought to describe the prevalence of HIV, nutritional disorders, and noncommunicable diseases (NCDs) among members of tuberculosis-affected households in 3 African countries. A part of a multicountry cohort study, we screened for tuberculosis, HIV, nutritional disorders (underweight, anaemia, overweight/obesity), and NCDs (diabetes, hypertension, and chronic lung disease) among members of tuberculosis-affected households aged ≥10 years in Mozambique, Tanzania, and Zimbabwe. We describe the prevalence of these conditions, their co-occurence within individuals (multimorbidity) and household-level clustering. Of 2,109 household contacts recruited, 93% (n = 1,958, from 786 households) had complete data and were included in the analysis. Sixty-two percent were female, median age was 27 years, and 0.7% (n = 14) were diagnosed with co-prevalent tuberculosis. Six percent of household members (n = 120) had previous tuberculosis, 15% (n = 294) were living with HIV, 10% (n = 194) had chronic lung disease, and 18% (n = 347) were anaemic. Nine percent of adults (n = 127) had diabetes by HbA1c criteria, 32% (n = 439) had hypertension. By body mass index criteria, 18% household members (n = 341) were underweight while 29% (n = 549) were overweight or obese. Almost half the household members (n = 658) had at least 1 modifiable tuberculosis risk factor. Sixty-one percent of adults (n = 822) had at least 1 chronic condition, 1 in 4 had multimorbidity. While most people with HIV knew their status and were on treatment, people with NCDs were usually undiagnosed and untreated. Limitations of this study include use of point-of-care HbA1c for definition of diabetes and definition of hypertension based on single-day measurements. Households affected by tuberculosis also face multiple other health challenges. Integrated approaches to tuberculosis screening may represent an opportunity for identification and treatment, including prioritisation of individuals at highest risk for tuberculosis to receive preventive therapy.

SARS-CoV-2 Variants May Affect Saliva RT-PCR Assay Sensitivity.

Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) variants demonstrate predilection for different regions of the respiratory tract. While saliva-based reverse transcription-polymerase chain reaction (RT-PCR) testing is a convenient, cost-effective alternative to nasopharyngeal swabs (NPS), few studies to date have investigated whether saliva sensitivity differs across variants of concern. SARS-CoV-2 RT-PCR was performed on paired NPS and saliva specimens collected from individuals with acute coronavirus disease 2019 (COVID-19) symptoms or exposure to a COVID-19 household contact. Viral genome sequencing of NPS specimens and Los Angeles County surveillance data were used to determine the variant of infection. Saliva sensitivity was calculated using NPS-positive RT-PCR as the reference standard. Factors contributing to the likelihood of saliva SARS-CoV-2 RT-PCR positivity were evaluated with univariate and multivariable analyses. Between June 2020 and December 2022, 548 saliva samples paired with SARS-CoV-2 positive NPS samples were tested by RT-PCR. Overall, saliva sensitivity for SARS-CoV-2 detection was 61.7% (95% CI, 57.6%-65.7%). Sensitivity was highest with Delta infection (79.6%) compared to pre-Delta (58.5%) and Omicron (61.5%) (P = 0.003 and 0.01, respectively). Saliva sensitivity was higher in symptomatic individuals across all variants compared to asymptomatic cases [pre-Delta 80.6% vs 48.3% (P < 0.001), Delta 100% vs 72.5% (P = 0.03), Omicron 78.7% vs 51.2% (P < 0.001)]. Infection with Delta, symptoms, and high NPS viral load were independently associated with 2.99-, 3.45-, and 4.0-fold higher odds of SARS-CoV-2 detection by saliva-based RT-PCR (P = 0.004, <0.001, and <0.001), respectively. As new variants emerge, evaluating saliva-based testing approaches may be crucial to ensure effective virus detection.

Epidemiological and genetic aspects of pulmonary tuberculosis in Kazakhstan

ObjectiveTuberculosis is a major health problem in many countries, including Kazakhstan. Host genetics can affect TB risk, and epidemiological and social factors may contribute to disease progression. Due to the high incidence of pulmonary tuberculosis in the country, our research aimed to study the epidemiological and genetic aspects of pulmonary tuberculosis in Kazakhstan. Material and methods1026 participants of Central Asian origin were recruited in the study: 342 individuals diagnosed with active PTB, 342 household contacts, and 342 controls without a family history of TB. Genetic polymorphisms of selected genes were determined by real-time polymerase chain reaction. The association between the risk of pulmonary TB and polymorphisms was evaluated using logistic regression and assessed with the ORs and their corresponding 95 % CIs, and the significance level was determined as p < 0.05. ResultsEpidemiological data revealed that underweight BMI (χ² = 89.97, p < 0.001), employment (χ² = 39.28, p < 0.001), and diabetes (χ² = 12.38, p < 0.001) showed a significant association with PTB. A/T polymorphism of the IFG gene showed a lower risk, and A/A polymorphism showed an increased risk of susceptibility to TB. A/A polymorphism of the IFG gene was associated with an almost 3-fold increased risk of PTB, and A/T polymorphism of the IFG gene was associated with a decreased risk of PTB (OR = 0.67, 95 % CI = 0.49–0.92, p = 0.01). The analysis revealed a decreased risk of PTB for A/A polymorphism of the VDR ApaI (OR = 0.67, 95 % CI = 0.46–0.97, p < 0.05). A/A polymorphism of the TLR8 gene was associated with a 1.5-fold increased risk of PTB (OR = 1.53, 95 % CI = 1.00–2.33, p < 0.05). ConclusionResults showed that gender, employment, underweight BMI and diabetes are associated with PTB incidence in our study cohort. The A/A genotype of the IFG (rs2430561) and an A/A genotype of the TLR8 (rs3764880) genes were associated with an increased risk of PTB. A/T polymorphism of the IFG (rs2430561) and A/A polymorphism of the VDR ApaI were associated with a decreased risk of PTB.

Factors Influencing the Practices and Adherence of Isoniazid Prophylactic Therapy Among Under 5 Years Children in Tb Referral Units, Peshawar

&amp;lt;i&amp;gt;Importance&amp;lt;/i&amp;gt;: The under 5 years children of house hold contact with active tuberculosis cases is one of the main cause for the transmission of TB in pediatrics population, responsible for many complications and childhood mortality. &amp;lt;i&amp;gt;Objective&amp;lt;/i&amp;gt;: To determine the factors influencing the practice and adherence of Isoniazid Prophylactic Therapy (IPT) among under 5 years children of house hold with cases of active pulmonary tuberculosis. &amp;lt;i&amp;gt;Design: &amp;lt;/i&amp;gt;The study’s design was cross sectional. &amp;lt;i&amp;gt;Setting: &amp;lt;/i&amp;gt;This study was conducted in TB referral units of the National Tuberculosis Control Program in Peshawar City. &amp;lt;i&amp;gt;Participants&amp;lt;/i&amp;gt;: The study participants included patients with sputum-positive pulmonary TB having at least one under-5 years’ child in their household. Secondly, the doctors who were directly dealing with TB patients for diagnosis and treatments in referral units of the respective hospitals. &amp;lt;i&amp;gt;Results&amp;lt;/i&amp;gt;: Most of the patients reported that doctors neither got some information about the under-5 years&amp;apos; children at their family nor to bring them for TB screening. Just 13.2% patients (36 out of 273) conceded that doctors mentioned them for prophylactic treatment with Isoniazid (INH) medication for their contact positive under-5years children. But only 4 of these 36 patients [(11.11%) 1.46%of the aggregate] completed the IPT course for their under-5 year children for 6 months duration. (Table 2) All the doctors claimed that they got information about the presence of under five years household contact in the family of TB patients. While the majority of the doctors/physicians (80%) had recognized that they neither requested the patients for screening from their family contact nor to give INH medication for their prophylaxis. This study showed that the practice of IPT was 13.2% and the adherence rate was just 11.11%, and the main factors for this poor result were poor healthcare system, lack of awareness, financial constraint and attitude of the patients. &amp;lt;i&amp;gt;Conclusion: &amp;lt;/i&amp;gt;This study concludes that the extremely poor practice and adherence to isoniazid prophylactic therapy by doctors and patients in TB referral units in Peshawar city for under-5-year-old children of households with active tuberculosis patients was primarily caused by a lack of awareness, financial constraints, patient attitudes, and an inefficient healthcare system.

Assessing Post-traumatic Stress Disorder and Social Determinants Among COVID-19 Case-Contact Dyads in Household Settings.

Coronavirus disease 2019 (COVID-19)is a contagious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).The COVID-19 outbreak raised several public and mental health concerns including tremendous psychological distress. To assess post-traumatic stress disorder (PTSD) among COVID-19-positive patientsand household contacts and to determine the socio-demographic factors associated with PTSD in the study population. A cross-sectional study was conducted among COVID-19-positive patients and their family members in Ernakulam district. A daily list of COVID-19-positive patients was obtained from the district officials. Confirmed cases and their close contacts in households were contacted over telephone and were interviewed after obtaining consent. Post-traumatic stress was assessed by the PTSD Symptom Scale - Interview Version (PSS-I-5) questionnaire. There were 279 study participants, of whom 93 were COVID-19 positive and the remaining 186 were their contacts.More than a third (34, 36.6%) of cases suffered from PTSD while about a fifth (40, 21.5%) of contacts suffered from PTSD. Among cases, persons belonging to the below poverty line (BPL) had 2.9l (1.19, 7.24) times higher risk compared to those above poverty line (APL). Women also had a 2.8 (1.14, 7.01) higher odds compared to males. Among contacts, graduates had a 9.54 (95% CI: 1.84, 49.36) increased odds whereas homemakers were found to be protected (0.195 (0.06, 0.66)) against PTSD compared to the employed group. Psychological counselling and support are essential for addressing PTSD among women and those living with BPL, as these groups are disproportionately affected.

An adapted scale to measure perceived TB and HIV stigma during household contact investigation.

<sec><title>BACKGROUND</title>Measuring stigma for TB and HIV in households undergoing contact investigation for TB is critical for understanding its impacts on health behaviours and identifying opportunities for intervention. However, standardised measurements for TB-HIV stigma in household contact investigations are limited.</sec><sec><title>METHODS</title>We adapted and validated a household stigma scale in Uganda. This involved field testing measures from another setting with 163 household contacts of newly diagnosed TB patients, conducting cognitive interviews with seven household contacts, adapting scale items using cognitive interview data, and retesting the adapted scales in a random sample of 60 contacts. We assessed inter-item covariance and performed factor analysis to select the final scale items.</sec><sec><title>RESULTS</title>In whole-scale factor analysis, no cross-loading of items with scores ≥0.32 was found after the elimination of items based on covariance and symmetry. All TB items were loaded onto a single factor with scores ≥0.5, and all but one HIV item was loaded onto a second factor with scores ≥0.5. The final subscale internal consistency (Cronbach's alpha) was 0.92 for TB and 0.89 for HIV.</sec><sec><title>CONCLUSIONS</title>The adapted TB-HIV stigma scale demonstrated acceptable psychometric properties and is substantially shorter and easier to administer than previous scales, making it suitable for programmatic research and evaluation.</sec>.

Waiting is no longer an option for household contacts of people with drug-resistant tuberculosis

Waiting is no longer an option for household contacts of people with drug-resistant tuberculosis

Household contact management and preventive treatment for drug-resistant tuberculosis

Household contact management and preventive treatment for drug-resistant tuberculosis

Reduced Risk of SARS-CoV-2 Infection Among Household Contacts with Recent Vaccination and Past COVID-19 Infection: Results from Two Multi-Site Case-Ascertained Household Transmission Studies.

Households are a primary setting for transmission of SARS-CoV-2. We examined the role of prior SARS-CoV-2 immunity on the risk of infection in household close contacts. Households in the United States with an individual who tested positive for SARS-CoV-2 during September 2021-May 2023 were enrolled if the index case's illness began ≤6 days prior. Household members had daily self-collected nasal swabs tested by RT-PCR for SARS-CoV-2. The effects of prior SARS-CoV-2 immunity (vaccination, prior infection, or hybrid immunity) on SARS-CoV-2 infection risk among household contacts were assessed by robust, clustered multivariable Poisson regression. Of 1,532 contacts (905 households), 8% had immunity from prior infection alone, 51% from vaccination alone, 29% hybrid immunity, and 11% had no prior immunity. Sixty percent of contacts tested SARS-CoV-2-positive during follow-up. The adjusted risk of SARS-CoV-2 infection was lowest among contacts with vaccination and prior infection (aRR: 0.81, 95% CI: 0.70, 0.93, compared with contacts with no prior immunity) and was lowest when the last immunizing event occurred ≤6 months before COVID-19 affected the household (aRR: 0.69, 95% CI: 0.57, 0.83). In high-transmission settings like households, immunity from COVID-19 vaccination and prior infection was synergistic in protecting household contacts from SARS-CoV-2 infection.