Additional risk of developing TB for household members with a TB case at home at intake: a 15-year study
Abstract:OBJECTIVE: To assess the additional risk to household contacts from an infectious case of tuberculosis (TB) at home in a rural community in south India.
METHODS: In all, 3506 contacts of smear-positive (S+C+) and 2910 contacts of smear-negative TB cases (S−C+) and 246845 persons with no TB case at home were followed for 15 years, with a repeat survey every 2.5 years consisting of radiographic and sputum examination, selective follow-up of high-risk individuals and passive surveillance. If a case developed during follow-up, all household members were subsequently considered as contacts. Cox's proportional hazards model (multivariate) was employed to compare incidences.
RESULTS: The annual incidence of culture-positive TB was respectively 526 and 271 per 100000 population for contacts of smear-positive and smear-negative patients, and 198/100000 in non-contacts. The adjusted hazard rate was 3.4 for contacts of smear-positive patients (95%CI 3.0–3.9) and 1.7 for contacts of smear-negative patients (95%CI 1.4–2.0) as compared to non-contacts. Of 3942 incident cases, 337 (8.5%) came from households with a TB case.
CONCLUSION: Although family contacts had a significantly higher incidence, their contribution to total new caseload was meagre. Contact chemoprophylaxis as a public health measure would therefore have limited impact on community TB incidence.
Document Type: Regular Paper
Affiliations: Tuberculosis Research Centre, Indian Council of Medical Research, Chennai, India
Publication date: March 1, 2007
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