School and household tuberculosis contact investigations in Swaziland: Active TB case finding in a high HIV/TB burden setting
| العنوان: | School and household tuberculosis contact investigations in Swaziland: Active TB case finding in a high HIV/TB burden setting |
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| المؤلفون: | Bhekisisa Tsabedze, Piluca Ustero, Alexander W. Kay, Jessica Glickman, Anna M. Mandalakas, Bulisile Mzileni, Rachel Golin, Katherine Ngo, Gcinile Mavimbela, Mildred Wisile Xaba |
| المصدر: | PLoS ONE PLoS ONE, Vol 12, Iss 6, p e0178873 (2017) |
| سنة النشر: | 2017 |
| مصطلحات موضوعية: | 0301 basic medicine, Male, Bacterial Diseases, Physiology, Tuberculosis Contact, lcsh:Medicine, Social Sciences, HIV Infections, Adolescents, Geographical Locations, Families, 0302 clinical medicine, Sociology, Odds Ratio, Medicine and Health Sciences, Mass Screening, 030212 general & internal medicine, Young adult, lcsh:Science, Child, Children, Family Characteristics, Multidisciplinary, Schools, Coinfection, Body Fluids, Community-Acquired Infections, Actinobacteria, Professions, Infectious Diseases, Female, medicine.symptom, Anatomy, Research Article, Tuberculosis, Adolescent, 030106 microbiology, education, Education, 03 medical and health sciences, Young Adult, Environmental health, medicine, Humans, Tuberculosis, Pulmonary, Mass screening, Bacteria, business.industry, lcsh:R, Sputum, Organisms, Biology and Life Sciences, Teachers, Odds ratio, medicine.disease, Tropical Diseases, Mucus, Age Groups, People and Places, Africa, lcsh:Q, Population Groupings, Contact Tracing, Swaziland, business, Eswatini, Contact tracing, Mycobacterium Tuberculosis |
| الوصف: | Background Investigation of household contacts exposed to infectious tuberculosis (TB) is widely recommended by international guidelines to identify secondary cases of TB and limit spread. There is little data to guide the use of contact investigations outside of the household, despite strong evidence that most TB infections occur outside of the home in TB high burden settings. In older adolescents, the majority of infections are estimated to occur in school. Therefore, as part of a project to increase active case finding in Swaziland, we performed school contact investigations following the identification of a student with infectious TB. Methods The Butimba Project identified 7 adolescent TB index cases (age 10–20) with microbiologically confirmed disease attending 6 different schools between June 2014 and March 2015. In addition to household contact investigations, Butimba Project staff worked with the Swaziland School Health Programme (SHP) to perform school contact investigations. At 6 school TB screening events, between May and October 2015, selected students underwent voluntary TB screening and those with positive symptom screens provided sputum for TB testing. Results Among 2015 student contacts tested, 177 (9%) screened positive for TB symptoms, 132 (75%) produced a sputum sample, of which zero tested positive for TB. Household contact investigations of the same index cases yielded 40 contacts; 24 (60%) screened positive for symptoms; 19 produced a sputum sample, of which one case was confirmed positive for TB. The odds ratio of developing TB following household vs. school contact exposure was significantly lower (OR 0.0, 95% CI 0.0 to 0.18, P = 0.02) after exposure in school. Conclusion School-based contact investigations require further research to establish best practices in TB high burden settings. In this case, a symptom-based screening approach did not identify additional cases of tuberculosis. In comparison, household contact investigations yielded a higher percentage of contacts with positive TB screens and an additional tuberculosis case. |
| تدمد: | 1932-6203 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::d6b4294e6cbb090f355974ad72bce5d2 https://pubmed.ncbi.nlm.nih.gov/28582435 |
| Rights: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....d6b4294e6cbb090f355974ad72bce5d2 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 19326203 |
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