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Free Content Contact examination for tuberculosis in Hong Kong is useful

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SETTING: The tuberculosis programme of the Hong Kong Government Tuberculosis and Chest Service.

OBJECTIVE: To determine the outcome of examination of household contacts in Hong Kong.

DESIGN: A retrospective cohort study of all household contacts of 970 randomly selected index cases from a total of 5757 registered for treatment with the Chest Service.

RESULTS: Of 2678 household contacts (three/index case) identified, 90% were examined; 41 active cases were found, at a rate of 1720/100000 (95%CI 1238–2329). The rate was highest among two extremes of age, 3604/100000 (95%CI 990Ð3615) in children ≤5 years and 3347/100000 (95%CI 1456–6489) in those >60 years of age. Contacts of index cases whose sputum smear and culture were positive had the highest rate of disease, 2904/100000 (95%CI 1669–4673); but contacts with negative bacteriology also had a high rate of 1478/100000 (95%CI 678–2789). Active cases identified through contact tracing could be source cases rather than secondary cases. Eight per cent of children aged ≤5 years had positive tuberculin reactions; as BCG vaccination is given to all newborns, with 99% coverage in Hong Kong in the past 30 years, it was difficult to estimate the rate of infection in these children.

CONCLUSION: In Hong Kong, an area with an intermediate burden of tuberculosis, contact investigation is a very useful procedure for active case finding.
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Keywords: Hong Kong; contact examination; tuberculosis

Document Type: Regular Paper

Affiliations: 1: Department of Medicine, The University of Hong Kong, Hong Kong 2: Hong Kong Government Tuberculosis and Chest Service, Department of Health, Hong Kong 3: Department of Health Care and Epidemiology, University of British Columbia, Vancouver, Canada

Publication date: 2002-01-01

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  • The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.

    Certain IJTLD articles are selected for translation into French, Spanish, Chinese or Russian. They are available on the Union website

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