Investigation of household contacts of pulmonary tuberculosis patients increases case detection in Mwanza City, Tanzania
Date
2018-03
Journal Title
Journal ISSN
Volume Title
Publisher
BioMed Central
Abstract
Background: Tuberculosis (TB) contact tracing is a key strategy for containing TB and provides addition to the passive
case finding approach. However, this practice has not been implemented in Tanzania, where there is unacceptably
high treatment gap of 62.1% between cases estimated and cases detected. Therefore calls for more aggressive case
finding for TB to close this gap. We aimed to determine the magnitude and predictors of bacteriologically-confirmed
pulmonary TB among household contacts of bacteriologically-confirmed pulmonary TB index cases in the city of
Mwanza, Tanzania.
Methods: This study was carried out from August to December 2016 in Mwanza city at the TB outpatient
clinics of Tertiary Hospital of the Bugando Medical Centre, Sekou-Toure Regional Hospital, and Nyamagana
District Hospital. Bacteriologically-confirmed TB index cases diagnosed between May and July 2016 were
identified from the laboratory registers book. Contacts were traced by home visits by study TB nurses, and
data were collected using a standardized TB screening questionnaire. To detect the bacterioriologically-confirmed
pulmonary TB, two sputum samples per household contact were collected under supervision for all household
contacts following standard operating procedures. Samples were transported to the Bugando Medical Centre TB
laboratory for investigation for TB using fluorescent smear microscopy, GeneXpert MTB/RIF and Löwenstein–Jensen
(LJ) culture. Logistic regression was used to determine predictors of bacteriologically-confirmed pulmonary TB among
household contacts.
Results: During the study period, 456 household contacts from 93 TB index cases were identified. Among these
456 household contacts, 13 (2.9%) were GeneXpert MTB/RIF positive, 18 (3.9%) were MTB-culture positive and
four (0.9%) were AFB-smear positive. Overall, 29 (6.4%) of contacts had bacteriologically-confirmed pulmonary TB.
Predictors of bacteriologically-confirmed pulmonary TB among household contacts were7being married (Odds
ratio [OR], 3.3; 95% confidence interval [CI], 1.4–8.0; p = 0.012) and consuming less than three meals a day (OR, 3.7;
95% CI, 1.6–8.7; p = 0.009).
Conclusions: Our data suggest that in Mwanza, Tanzania, seven in 100 contacts living in the same house with a
TB patient develop bacteriologically-confirmed pulmonary TB. These results therefore underscore the need to
implement routine TB contact tracing to control tuberculosis in high TB burden countries such as Tanzania.
Description
CITATION: Beyanga, M. et al. 2018. Investigation of household contacts of pulmonary tuberculosis patients increases case detection in Mwanza City, Tanzania. BMC Infectious Diseases, 18:110, doi.org/10.1186/s12879-018-3036-6.
The original publication is available at https://bmcinfectdis.biomedcentral.com
The original publication is available at https://bmcinfectdis.biomedcentral.com
Keywords
Tuberculosis, Bacteriologically-confirmed pulmonary tuberculosis, Mwanza, Tanzania, TB, Containing TB, Mycobacterium tuberculosis
Citation
Beyanga, M. et al. 2018. Investigation of household contacts of pulmonary tuberculosis patients increases case detection in Mwanza City, Tanzania. BMC Infectious Diseases, 18:110, doi.org/10.1186/s12879-018-3036-6.