Early and late tuberculosis risks among close contacts in Hong Kong
Abstract:SETTING: Tuberculosis (TB) notification is a statutory requirement in Hong Kong, where contact investigations are performed by the Tuberculosis and Chest Service.
OBJECTIVES: 1) To evaluate the risk of active TB in close contacts within 5 years, and 2) to identify risk factors associated with early and late development of active TB disease.
DESIGN: The characteristics of consecutive TB cases notified from 18 January to 17 April 2000 were collected together with those of their contacts. Contacts were prospectively followed up through the territory-wide TB notification registry for 5 years for the development of disease.
RESULTS: A total of 1537 index cases and 4661 close contacts were analysed. Screening found 31 (0.67%) active TB cases within a 3-month period, and another 58 (1.24%) cases presented subsequently. Index cases with cough or pulmonary cavities and diabetic contacts were independent risk factors of early cases (all P < 0.05). Adjusted at risk index characteristics for late TB development included positive sputum smear (2.79, 95%CI 1.31–5.95) and family history of TB (4.26, 95%CI 2.01–9.03). Contact risk factors included diabetes mellitus (3.44, 95%CI 1.04–11.33) and institutionalisation (3.61, 95%CI 1.70–7.65).
CONCLUSION: Considerable TB risk remains after initial contact screening. A number of possible risk factors were identified.
Document Type: Regular Paper
Affiliations: 1: Tuberculosis and Chest Service, Public Health Service Branch, Centre of Health Protection, Department of Health, Hong Kong, China 2: Public Health Laboratory Services Branch, Centre of Health Protection, Department of Health, Hong Kong, China
Publication date: March 1, 2008
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