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TST positivity in household contacts of tuberculosis patients : a case-contact study in Malawi
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dc.contributor.author | Hector, Jonas | |
dc.contributor.author | Anderson, Suzanne T. | |
dc.contributor.author | Banda, Gertrude | |
dc.contributor.author | Kamdolozi, Mercy | |
dc.contributor.author | Jefferys, Laura F. | |
dc.contributor.author | Shani, Doris | |
dc.contributor.author | Garton, Natalie J. | |
dc.contributor.author | Mwale, Agnes | |
dc.contributor.author | Jobe, Annie | |
dc.contributor.author | Davies, Geraint R. | |
dc.contributor.author | Sloan, Derek J. | |
dc.date.accessioned | 2017-04-11T11:30:20Z | |
dc.date.available | 2017-04-11T11:30:20Z | |
dc.date.issued | 2017-04-11 | |
dc.identifier.citation | Hector , J , Anderson , S T , Banda , G , Kamdolozi , M , Jefferys , L F , Shani , D , Garton , N J , Mwale , A , Jobe , A , Davies , G R & Sloan , D J 2017 , ' TST positivity in household contacts of tuberculosis patients : a case-contact study in Malawi ' , BMC Infectious Diseases , vol. 17 , 259 . https://doi.org/10.1186/s12879-017-2348-2 | en |
dc.identifier.issn | 1471-2334 | |
dc.identifier.other | PURE: 249655718 | |
dc.identifier.other | PURE UUID: 5736785c-2a17-46a9-8190-09a4d997c2b2 | |
dc.identifier.other | RIS: Hector2017 | |
dc.identifier.other | Scopus: 85018477998 | |
dc.identifier.other | WOS: 000398903200005 | |
dc.identifier.other | ORCID: /0000-0002-7888-5449/work/60631031 | |
dc.identifier.uri | https://hdl.handle.net/10023/10608 | |
dc.description | This work was supported by a Wellcome Trust Fellowship awarded to DJ Sloan (086757/Z/08/A) a Malawi Liverpool Wellcome Trust (MLW) Core grant awarded by the Wellcome Trust and by a grant from the European Union Action for Diseases of Poverty Program (Sante–2006–105-061). | en |
dc.description.abstract | Background: Screening household contacts of active tuberculosis (TB) patients is recommended for TB control. Due to resource constraints this rarely occurs in lower income countries. Demographic and clinical features of index cases may influence the likelihood of onwards TB transmission. It has also been proposed that accumulation of intracellular lipid bodies within M. tuberculosis cells may also enhance bacterial transmissibility. This study explored whether clinical and bacteriological observations recorded at baseline in TB cases in Malawi could help identify those with the highest risk of onwards transmission, to prioritise contact tracing. Methods: In this case-contact study, data on clinical presentation, sputum bacterial load and the percentage of lipid body positive acid-fast bacilli (%LB + AFB) on sputum smears were recorded in adults with sputum smear and culture positive pulmonary TB before initiation of therapy. The Tuberculin Skin Test (TST) was used to detect infection with M. tuberculosis amongst household contacts under the age of 15 years. TST positivity of the child contacts was related to characteristics of the index case. Results: Thirty four index cases brought 56 contacts (median: 1, range: 1–4 contacts each). 37 (66%) of contacts had a positive TST. Cavities or a high percentage of lung affected on index patient CXRs were associated with TST positivity. Multivariate analysis of non-radiological factors showed that male sex, HIV-negative status and raised peripheral blood white blood count (WBC) in index patients were also independent risk factors of TST positivity. Lower %LB + AFB counts were associated with TST positivity on univariate analysis only. Conclusion: TST positivity is common amongst household contacts of sputum smear positive adult TB patients in Malawi. Contact tracing in this high risk population could be guided by prioritising index cases with CXR cavities and extensive radiological disease or, in the absence of CXRs, those who are HIV-negative with a raised WBC. | |
dc.format.extent | 7 | |
dc.language.iso | eng | |
dc.relation.ispartof | BMC Infectious Diseases | en |
dc.rights | © The Author(s) 2017 Open Access. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. | en |
dc.subject | Tuberculosis | en |
dc.subject | HIV status | en |
dc.subject | Contact screening | en |
dc.subject | Tuberculosis skin test | en |
dc.subject | White blood cell count | en |
dc.subject | Malawi | en |
dc.subject | Lipid body | en |
dc.subject | RA0421 Public health. Hygiene. Preventive Medicine | en |
dc.subject | NDAS | en |
dc.subject | SDG 3 - Good Health and Well-being | en |
dc.subject.lcc | RA0421 | en |
dc.title | TST positivity in household contacts of tuberculosis patients : a case-contact study in Malawi | en |
dc.type | Journal article | en |
dc.description.version | Publisher PDF | en |
dc.contributor.institution | University of St Andrews. School of Medicine | en |
dc.contributor.institution | University of St Andrews. Infection and Global Health Division | en |
dc.identifier.doi | https://doi.org/10.1186/s12879-017-2348-2 | |
dc.description.status | Peer reviewed | en |
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