Seid Getachew, Alemu Ayinalem, Diriba Getu, Zerihun Betselot, Abebaw Yeshiwork, Moga Shewki, Abdela Saro, Habtemariam Solomon, Gumi Balako
Ethiopian Public Health Institute, P.o.box 1242, Addis Ababa Ethiopia.
Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Po. Box 1176, Addis Ababa, Ethiopia.
Heliyon. 2024 May 9;10(10):e30942. doi: 10.1016/j.heliyon.2024.e30942. eCollection 2024 May 30.
There is a global gap between tuberculosis incident cases and the notified cases. Active household contact investigation is one of the strategies to narrow this gap. It has the advantage of giving early diagnosis and preventive treatment to vulnerable and eligible groups. This study assessed the practice of contact investigation and tuberculosis preventive treatment adherence in central Ethiopia.
A cross-sectional study covering all registered bacteriologically confirmed pulmonary tuberculosis patients and their close contacts was conducted in central Ethiopia from January 1, 2022, to December 30, 2022.
A total of 1372 household contacts were declared by the index cases. From these 79.44 % (1090) contacts received a one-time tuberculosis screening giving a total of four (0.36 %) active TB cases. Among 484 household contacts of drug-resistant tuberculosis index cases, 5.53 % (14) had presumptive tuberculosis and 0.79 % (2) had active tuberculosis. While among 837 household contacts of drug-susceptible tuberculosis index cases presumptive TB cases were 1.91 % (16) and active TB cases were 0.23 % (2). Of the 142 eligible under 15 children 81.69 % (116) had started tuberculosis preventive treatment and 84.48 % (98) completed the treatment. On multivariable logistic regression, the associated factor for tuberculosis preventive treatment non-adherence was age 2-5 years (aOR, 0.02, 95 % CI (0.002-0.20) and age 5-15 years (aOR, 0.04,95 % CI (0.002-0 0.95)) P=<0.05).
There was low contact screening practice in the DR-TB index cases as compared to national and global targets. The yield of routine contact investigation was low and it indicates the quality of screening. Tuberculosis preventive treatment initiation and completion rates were also low as compared to those of many other countries and global achievements which need further improvement, especially for completion. Alternative mechanisms should be planned to increase the yield of tuberculosis screening and tuberculosis preventive treatment adherence.
全球结核病发病病例与报告病例之间存在差距。积极开展家庭接触者调查是缩小这一差距的策略之一。它具有为脆弱且符合条件的人群提供早期诊断和预防性治疗的优势。本研究评估了埃塞俄比亚中部地区接触者调查的实施情况以及结核病预防性治疗的依从性。
于2022年1月1日至2022年12月30日在埃塞俄比亚中部开展了一项横断面研究，涵盖所有登记的经细菌学确诊的肺结核患者及其密切接触者。
索引病例共申报了1372名家庭接触者。其中79.44%（1090名）接触者接受了一次性结核病筛查，共发现4例（0.36%）活动性肺结核病例。在耐多药结核病索引病例的484名家庭接触者中，5.53%（14名）有疑似结核病，0.79%（2名）有活动性结核病。而在敏感结核病索引病例的837名家庭接触者中，疑似结核病病例为1.91%（16名），活动性结核病病例为0.23%（2名）。在142名符合条件的15岁以下儿童中，81.69%（116名）开始了结核病预防性治疗，84.48%（98名）完成了治疗。多变量逻辑回归分析显示，结核病预防性治疗不依从的相关因素为2至5岁（调整后比值比，0.02，95%置信区间（0.002 - 0.20））和5至15岁（调整后比值比，0.04，95%置信区间（0.002 - 0.95）），P < 0.05）。
与国家和全球目标相比，耐多药结核病索引病例的接触者筛查实施情况较差。常规接触者调查的检出率较低，这表明筛查质量不高。与许多其他国家及全球成果相比，结核病预防性治疗的启动率和完成率也较低，需要进一步改进，尤其是完成率方面。应规划替代机制以提高结核病筛查的检出率和结核病预防性治疗的依从性。
