Fuchs Andre, Tufa Tafese Beyene, Pfäfflin Frieder, Schönfeld Andreas, Nordmann Tamara, Melaku Fikru, Sorsa Abebe, Orth Hans Martin, Häussinger Dieter, Luedde Tom, Feldt Torsten
Hirsch Institute of Tropical Medicine, Asella, Ethiopia.
Internal Medicine III - Gastroenterology and Infectious Diseases, University Hospital of Augsburg, Augsburg, Germany.
IJID Reg. 2022 Mar 20;3:196-203. doi: 10.1016/j.ijregi.2022.03.012. eCollection 2022 Jun.
The World Health Organization recommends active case finding for tuberculosis (TB). Our study evaluated the targeted screening of household contacts (HHCs) of patients with contagious pulmonary tuberculosis (PTB) in Central Ethiopia.
The HHCs of patients with microbiologically confirmed PTB were screened for TB symptoms and risk factors for TB transmission. Symptomatic HHCs were subjected to secondary investigation. Antimicrobial resistance was investigated among study participants.
Overall, 112 index patients with TB were included, and 289 HHCs from 89 households were screened. Multidrug-resistant-TB was detected in 2.7% (n=3) of index patients. The routine public health system process did not identify any TB suspects among HHCs. In total, 23.9% (n=69) of HHCs reported ≥1 TB symptom and PTB was confirmed in 2.1% (n=6). Reporting >1 TB symptom (relative risk [RR] 29.4, 95% CI 3.5-245.5, <0.001) and night sweats (RR 27.1, 95% CI 3.2-226.6, <0.001) were associated with the greatest relative risk. Regular alcohol consumption was identified as an individual risk factor for TB among HHCs (=0.022).
The MDR-TB rate among our patients was higher than recently reported for Ethiopia. Enhanced contact tracing using a risk-adjusted approach seems feasible and increases the case detection rate among HHCs of confirmed TB cases.
世界卫生组织建议对结核病(TB)进行主动病例发现。我们的研究评估了在埃塞俄比亚中部对传染性肺结核(PTB)患者的家庭接触者(HHCs)进行针对性筛查的情况。
对微生物学确诊的PTB患者的HHCs进行结核病症状和结核病传播风险因素筛查。有症状的HHCs接受二次调查。对研究参与者进行耐药性调查。
总体而言,纳入了112例结核病索引患者,并对来自89户家庭的289名HHCs进行了筛查。在2.7%(n = 3)的索引患者中检测到耐多药结核病。常规公共卫生系统流程未在HHCs中识别出任何结核病疑似病例。总共有23.9%(n = 69)的HHCs报告有≥1种结核病症状,2.1%(n = 6)的患者确诊为PTB。报告>1种结核病症状(相对风险[RR] 29.4,95%可信区间3.5 - 245.5,<0.001)和盗汗(RR 27.1,95%可信区间3.2 - 226.6,<0.001)与最高相对风险相关。经常饮酒被确定为HHCs中结核病的个体风险因素(P = 0.022)。
我们患者中的耐多药结核病率高于埃塞俄比亚最近报告的水平。采用风险调整方法加强接触者追踪似乎可行,并提高了确诊结核病病例的HHCs中的病例发现率。