Tamil Nadu Health System Reform Program (Supported By World Bank), Directorate of Medical and Rural Health Services, DMS Annex, Government of Tamil Nadu, Teynampet, Chennai, 600006, India.
Indian J Tuberc. 2020 Oct;67(4):459-465. doi: 10.1016/j.ijtb.2020.07.007. Epub 2020 Jul 13.
This study was a cross sectional done among 220 household contacts of age 12 years and above (male and female) of the index sputum positive patients receiving DOTS. Mantoux skin test (Tuberculin Skin Test - TST) was administered by the principal investigator along with TST reading & final diagnosis. Chi-square test was done to find out the association.
Out of 220 household contacts tested, 43.6% (96) tested positive for latent TB (induration ≥10mm) with 95% CI ranging from 37% to 50%. The prevalence of latent TB among men and women are 35.6% and 49.2% respectively the difference between which is found to be statistically significant (p = 0.04). Odds Ratio of 5.5 was noted among study subjects who were diabetic (p = 0.018). Household contacts of index patients taking CAT II were at a higher risk than that of CAT I.
This study clearly shows the high prevalence of latent TB infection among household contacts of sputum positive patients receiving DOTS and so RNTCP should include them in IPT along with under 6 children. The household contacts who spend most time with the index case, who sleep close to them within 5 feet, female household contacts, students, diabetic household contacts are at a significantly higher risk than others.
这是一项横断面研究，纳入了 220 名年龄在 12 岁及以上（男性和女性）的痰阳性患者家庭接触者，这些患者正在接受 DOTS 治疗。主要研究者进行了曼托斯皮肤试验（结核菌素皮肤试验-TST），并进行了 TST 阅读和最终诊断。采用卡方检验来确定相关性。
在 220 名接受测试的家庭接触者中，有 43.6%（96 名）对潜伏性结核呈阳性（硬结≥10mm），95%可信区间为 37%至 50%。男性和女性的潜伏性结核患病率分别为 35.6%和 49.2%，两者之间的差异具有统计学意义（p=0.04）。患有糖尿病的研究对象的优势比为 5.5（p=0.018）。与 CAT I 相比，CAT II 组的家庭接触者面临更高的风险。
这项研究清楚地表明，接受 DOTS 治疗的痰阳性患者家庭接触者中潜伏性结核感染的流行率很高，因此 RNTCP 应将他们与 6 岁以下儿童一起纳入 IPT。与其他家庭接触者相比，与指标病例相处时间最长、与指标病例距离在 5 英尺内睡觉、女性家庭接触者、学生、糖尿病家庭接触者的风险显著更高。
