Source case identification in HIV-exposed infants and tuberculosis diagnosis in an isoniazid prevention study

Elke Regina Maritz, G. Montepiedra, L. Liu, Charles D Mitchell, S. A. Madhi, R. Bobat, A. Violari, A. Ogwu, A. C. Hesseling, M. F. Cotton

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

BACKGROUND: Identifying source cases of children exposed to tuberculosis (TB) is challenging. We examined the time-point of obtaining contact information of TB source cases in human immunodeficiency virus (HIV) infected and HIV-exposed uninfected (HEU) children in a randomised, placebo-controlled trial of pre-exposure to isoniazid prophylaxis. METHODS : A total of 543 HIV-infected and 808 HEU infants without TB exposure aged 3-4 months were enrolled between 2004 and 2008. At 3-monthly followup, infants were evaluated for TB and care givers were asked about new TB exposure. RESULT S : In total, 128 cases of TB disease and 40 deaths were recorded among 19% (105/543) of the HIVinfected and 8% (63/808) of the HEU children; 229 TB contact occasions were reported in 205/1351 (15%) children, of which 83% (189/229) were in the household. Of the 189 household contacts, 108 (53%) underwent microbiological evaluations; 81% (87/108) were positive. HIV-infected and HEU infants had similar frequencies of TB contact: in 48% of infants with definite TB, 58% with probable TB and 43% with possible TB. Of 128 children diagnosed with TB, a TB contact was identified for 59. Of these, 29/59 (49%) were identified at or after the child's TB diagnosis. CONCLUS ION: TB source cases are often identified at or after a child's TB diagnosis. More effort is required for earlier detection.

Original languageEnglish (US)
Pages (from-to)1060-1064
Number of pages5
JournalInternational Journal of Tuberculosis and Lung Disease
Volume20
Issue number8
DOIs
StatePublished - Aug 1 2016

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Isoniazid
Tuberculosis
HIV
Caregivers

Keywords

  • Child TB diagnosis
  • HIVexposed
  • Source case

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Infectious Diseases

Cite this

Source case identification in HIV-exposed infants and tuberculosis diagnosis in an isoniazid prevention study. / Maritz, Elke Regina; Montepiedra, G.; Liu, L.; Mitchell, Charles D; Madhi, S. A.; Bobat, R.; Violari, A.; Ogwu, A.; Hesseling, A. C.; Cotton, M. F.

In: International Journal of Tuberculosis and Lung Disease, Vol. 20, No. 8, 01.08.2016, p. 1060-1064.

Research output: Contribution to journalArticle

Maritz, ER, Montepiedra, G, Liu, L, Mitchell, CD, Madhi, SA, Bobat, R, Violari, A, Ogwu, A, Hesseling, AC & Cotton, MF 2016, 'Source case identification in HIV-exposed infants and tuberculosis diagnosis in an isoniazid prevention study', International Journal of Tuberculosis and Lung Disease, vol. 20, no. 8, pp. 1060-1064. https://doi.org/10.5588/ijtld.15.0602
Maritz, Elke Regina ; Montepiedra, G. ; Liu, L. ; Mitchell, Charles D ; Madhi, S. A. ; Bobat, R. ; Violari, A. ; Ogwu, A. ; Hesseling, A. C. ; Cotton, M. F. / Source case identification in HIV-exposed infants and tuberculosis diagnosis in an isoniazid prevention study. In: International Journal of Tuberculosis and Lung Disease. 2016 ; Vol. 20, No. 8. pp. 1060-1064.
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AU - Montepiedra, G.

AU - Liu, L.

AU - Mitchell, Charles D

AU - Madhi, S. A.

AU - Bobat, R.

AU - Violari, A.

AU - Ogwu, A.

AU - Hesseling, A. C.

AU - Cotton, M. F.

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N2 - BACKGROUND: Identifying source cases of children exposed to tuberculosis (TB) is challenging. We examined the time-point of obtaining contact information of TB source cases in human immunodeficiency virus (HIV) infected and HIV-exposed uninfected (HEU) children in a randomised, placebo-controlled trial of pre-exposure to isoniazid prophylaxis. METHODS : A total of 543 HIV-infected and 808 HEU infants without TB exposure aged 3-4 months were enrolled between 2004 and 2008. At 3-monthly followup, infants were evaluated for TB and care givers were asked about new TB exposure. RESULT S : In total, 128 cases of TB disease and 40 deaths were recorded among 19% (105/543) of the HIVinfected and 8% (63/808) of the HEU children; 229 TB contact occasions were reported in 205/1351 (15%) children, of which 83% (189/229) were in the household. Of the 189 household contacts, 108 (53%) underwent microbiological evaluations; 81% (87/108) were positive. HIV-infected and HEU infants had similar frequencies of TB contact: in 48% of infants with definite TB, 58% with probable TB and 43% with possible TB. Of 128 children diagnosed with TB, a TB contact was identified for 59. Of these, 29/59 (49%) were identified at or after the child's TB diagnosis. CONCLUS ION: TB source cases are often identified at or after a child's TB diagnosis. More effort is required for earlier detection.

AB - BACKGROUND: Identifying source cases of children exposed to tuberculosis (TB) is challenging. We examined the time-point of obtaining contact information of TB source cases in human immunodeficiency virus (HIV) infected and HIV-exposed uninfected (HEU) children in a randomised, placebo-controlled trial of pre-exposure to isoniazid prophylaxis. METHODS : A total of 543 HIV-infected and 808 HEU infants without TB exposure aged 3-4 months were enrolled between 2004 and 2008. At 3-monthly followup, infants were evaluated for TB and care givers were asked about new TB exposure. RESULT S : In total, 128 cases of TB disease and 40 deaths were recorded among 19% (105/543) of the HIVinfected and 8% (63/808) of the HEU children; 229 TB contact occasions were reported in 205/1351 (15%) children, of which 83% (189/229) were in the household. Of the 189 household contacts, 108 (53%) underwent microbiological evaluations; 81% (87/108) were positive. HIV-infected and HEU infants had similar frequencies of TB contact: in 48% of infants with definite TB, 58% with probable TB and 43% with possible TB. Of 128 children diagnosed with TB, a TB contact was identified for 59. Of these, 29/59 (49%) were identified at or after the child's TB diagnosis. CONCLUS ION: TB source cases are often identified at or after a child's TB diagnosis. More effort is required for earlier detection.

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