Jude Simon, Abedi Ali J, Mehnaz Saira, Shameem Mohammad
Department of Community Medicine, Jawaharlal Nehru Medical College and Hospital, Aligarh Muslim University, Uttar Pradesh, India.
Indian J Community Med. 2025 Jan-Feb;50(1):181-186. doi: 10.4103/ijcm.ijcm_149_23. Epub 2025 Jan 23.
Engaging patients in healthcare for diagnosis and treatment through active case-finding, which is initiated by healthcare providers, involves methodically searching for tuberculosis in individuals who may not seek medical attention otherwise. Active case finding provides a promising opportunity to identify additional undetected cases of tuberculosis within the community. The current study aimed at evaluating household contact tracing of Tuberculosis among the household contacts of pulmonary TB cases who were recently diagnosed, as well as to identify risk factors in both household contacts and index cases that contribute to the transmission of TB within households.
This cross-sectional study, which was conducted within the community, focused on the household contacts of recently diagnosed patients of Pulmonary Tuberculosis (TB) who were confirmed through microbiological testing. These patients were registered at Tuberculosis Units (TUs) of JNMC and Jawan of Aligarh district, West U.P. The investigator conducted visits to each household and met with both the index case and their corresponding household contacts to establish rapport and gather necessary information.
Within this investigation, a total of 103 individuals who tested positive for sputum smear were identified as index cases, alongside 405 household contacts of these index cases. The predominant symptom observed in household contacts who tested positive during the screening process was a cough, with fever following closely behind. Among the 405 household contacts examined, 54 individuals (13.3%) exhibited symptoms associated with Tuberculosis. Further investigation revealed that 11 of these individuals (20.37%) tested positive for tuberculosis. The total prevalence of tuberculosis cases among household contacts was determined to be 2.72%.
The present research affirms that conducting contact screening for households of active TB cases is a comparatively feasible and beneficial strategy that could result in prompt diagnosis and initiation of treatment for active TB, thereby diminishing the severity of the disease and lowering the rate of transmission. Also, it can help to improve TB-related health effects, social and economic implications, and treatment outcomes in the index cases.
通过主动病例发现让患者参与到医疗保健的诊断和治疗中,这由医疗服务提供者发起,涉及有步骤地在那些原本可能不会寻求医疗护理的个体中查找结核病。主动病例发现为在社区内识别更多未被发现的结核病病例提供了一个有前景的机会。当前研究旨在评估近期诊断出的肺结核病例的家庭接触者中的结核病家庭接触者追踪情况,并确定家庭接触者和索引病例中导致家庭内结核病传播的危险因素。
这项在社区内开展的横断面研究聚焦于通过微生物检测确诊的近期诊断出的肺结核(TB)患者的家庭接触者。这些患者在北方邦西部阿里格尔区JNMC和贾万的结核病防治单位登记。研究者走访了每户家庭,与索引病例及其相应的家庭接触者会面,以建立融洽关系并收集必要信息。
在此次调查中,共有103名痰涂片检测呈阳性的个体被确定为索引病例,以及这些索引病例的405名家庭接触者。在筛查过程中检测呈阳性的家庭接触者中观察到的主要症状是咳嗽,发热紧随其后。在接受检查的405名家庭接触者中,54人(13.3%)表现出与结核病相关的症状。进一步调查显示,这些人中有11人(20.37%)结核病检测呈阳性。家庭接触者中结核病病例的总患病率确定为2.72%。
本研究证实,对活动性结核病病例的家庭进行接触者筛查是一种相对可行且有益的策略,这可能导致对活动性结核病的及时诊断和治疗启动,从而减轻疾病的严重程度并降低传播率。此外,它有助于改善索引病例中与结核病相关的健康影响、社会和经济影响以及治疗结果。