Feasibility of Identifying Household Contacts of Rifampin-and Multidrug-resistant Tuberculosis Cases at High Risk of Progression to Tuberculosis Disease
| Autor: | Xingye Wu, Francesca Conradie, Betsy Smith, Mark Harrington, Umesh G. Lalloo, Rodney Dawson, Linda Naini, Michael Hughes, Lynne Jones, Aida Asmelash, N. Sarita Shah, Susan Swindells, Anthony J. Garcia-Prats, Anneke C. Hesseling, Amita Gupta, Kyla Comins, Alberto Mendoza, Soyeon Kim, Jorge Sanchez, Justin Shenje, Nagalingeswaran Kumarasamy, Ana Cristina Garcia Ferreira, Christopher Mugah, Supalert Nedsuwan, Gavin J. Churchyard, Vidya Mave, Pedro Gonzales, Samyra R. Cox, Sandy Nerette Fontain, Lerato Mohapi |
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| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
0301 basic medicine
Microbiology (medical) Adult Male medicine.medical_specialty Tuberculosis 030106 microbiology Interferon gamma release assay Tuberculin Disease 03 medical and health sciences 0302 clinical medicine Internal medicine Tuberculosis Multidrug-Resistant Medicine Humans 030212 general & internal medicine Articles and Commentaries Family Characteristics business.industry Tuberculin Test medicine.disease Multiple drug resistance Clinical trial Preventive therapy Infectious Diseases Cross-Sectional Studies Child Preschool Sputum Feasibility Studies Female medicine.symptom Rifampin business |
| Zdroj: | Clin Infect Dis |
| Popis: | Background We assessed multidrug-resistant tuberculosis (MDR-TB) cases and their household contacts (HHCs) to inform the development of an interventional clinical trial. Methods We conducted a cross-sectional study of adult MDR-TB cases and their HHCs in 8 countries with high TB burdens. HHCs underwent symptom screenings, chest radiographies, sputum TB bacteriologies, TB infection (TBI) testing (tuberculin skin test [TST] and interferon gamma release assay [IGRA]), and human immunodeficiency virus (HIV) testing. Results From October 2015 to April 2016, 1016 HHCs from 284 MDR-TB cases were enrolled. At diagnosis, 69% of MDR-TB cases were positive for acid-fast bacilli sputum smears and 43% had cavitary disease; at study entry, 35% remained smear positive after a median MDR-TB treatment duration of 8.8 weeks. There were 9 HHCs that were diagnosed with TB prior to entry and excluded. Of the remaining 1007 HHCs, 41% were male and the median age was 25 years. There were 121 (12%) HHCs that had new cases of TB identified: 17 (2%) were confirmed, 33 (3%) probable, and 71 (7%) possible TB cases. The TBI prevalence (defined as either TST or IGRA positivity) was 72% and varied by age, test used, and country. Of 1007 HHCs, 775 (77%) were considered high-risk per these mutually exclusive groups: 102 (10%) were aged Conclusions The majority of HHCs in these high-burden countries were at high risk of TB disease and infection, yet few were receiving routine preventive therapy. Trials of novel, preventive therapies are urgently needed to inform treatment policy and practice. |
| Databáze: | OpenAIRE |
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