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

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

Research output: Contribution to journalArticle

5 Scopus citations

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

Keywords

  • Child TB diagnosis
  • HIVexposed
  • Source case

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Infectious Diseases

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    Maritz, E. R., Montepiedra, G., Liu, L., Mitchell, C. D., Madhi, S. A., Bobat, R., Violari, A., Ogwu, A., Hesseling, A. C., & Cotton, M. F. (2016). Source case identification in HIV-exposed infants and tuberculosis diagnosis in an isoniazid prevention study. International Journal of Tuberculosis and Lung Disease, 20(8), 1060-1064. https://doi.org/10.5588/ijtld.15.0602