Risk and Timing of Tuberculosis Among Close Contacts of Persons with Infectious Tuberculosis.

Autor:	Reichler MR; National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia., Khan A; National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia., Sterling TR; Vanderbilt University Medical Center, Nashville, Tennessee., Zhao H; National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia., Moran J; New York City Department of Health.; Charles P. Felton Tuberculosis Center, New York, New York., McAuley J; Respiratory Lung Association.; Rush University, Chicago, Illinois., Bessler P; National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia., Mangura B; New Jersey Medical School National Tuberculosis Center, Newark, New Jersey.
Jazyk:	angličtina
Zdroj:	The Journal of infectious diseases [J Infect Dis] 2018 Aug 14; Vol. 218 (6), pp. 1000-1008.
DOI:	10.1093/infdis/jiy265
Abstrakt:	Background: The risk and timing of tuberculosis among recently exposed close contacts of patients with infectious tuberculosis are not well established. Methods: We prospectively enrolled patients ≥15 years of age with culture-confirmed pulmonary tuberculosis and their close contacts at 9 health departments in the United States and Canada. Close contacts were screened and cross-matched with tuberculosis registries to identify those who developed tuberculosis. Results: Tuberculosis was diagnosed in 158 of 4490 contacts (4%) of 718 index patients with tuberculosis. Of tuberculosis cases among contacts, cumulative totals of 81 (51%), 119 (75%), 128 (81%), and 145 (92%) were diagnosed by 1, 3, 6, and 12 months, respectively, after the index patients' diagnosis. Tuberculosis rates among contacts were 2644, 115, 46, 69, and 25 cases per 100000 persons, respectively, in the 5 consecutive years after the index patients' diagnosis. Of the tuberculosis cases among contacts, 121 (77%) were identified by contact investigation and 37 (23%) by tuberculosis registry cross-match. Conclusions: Close contacts to infectious patients with tuberculosis had high rates of tuberculosis, with most disease diagnosed before or within 3 months after the index patient' diagnosis. Contact investigations need to be prompt to detect tuberculosis and maximize the opportunity to identify and treat latent infection, to prevent disease.
Databáze:	MEDLINE
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