Long-term follow-up of contacts exposed to multidrug-resistant tuberculosis in Victoria, Australia, 1995–2010
Abstract:SETTING: The effectiveness of public health strategies following exposure to multidrug-resistant tuberculosis (MDR-TB) is not clear.
OBJECTIVE: To perform long-term follow-up of MDR-TB contacts and review individual outcomes and management approaches.
DESIGN: Retrospective review of MDR-TB contacts identified by the Victorian Department of Health from 1995 to 2010. Health records, including personal medical and pharmacy records and statewide clinical and laboratory TB databases, were searched to identify management strategies and individual outcomes.
RESULTS: A total of 570 contacts of 47 MDR-TB cases were identified, with a total follow-up period of 3093 person-years of observation (PYO) since exposure. Of 570 contacts, 49 (8.6%) were considered likely to have been infected with Mycobacterium tuberculosis from index cases, and 11/49 (22.5%) of these were prescribed preventive therapy tailored to isolate susceptibility. No MDR-TB cases occurred in those receiving preventive treatment, while two cases were observed in those not treated (incidence 2878/100 000 PYO during the first 2 years post exposure).
CONCLUSIONS: The risk of MDR-TB transmission to close contacts in this low-prevalence setting highlights the potential for public health strategies involving preventive treatment.
Document Type: Research Article
Affiliations: 1: Victorian Infectious Diseases Service, Royal Melbourne Hospital and Department of Medicine, University of Melbourne, Parkville, Victoria, Australia 2: Victorian Infectious Diseases Reference Laboratory, Melbourne, Victoria, Australia 3: Department of Infectious Diseases, Monash Medical Centre, Clayton, Victoria, Australia 4: Infectious Diseases Unit, St Vincent's Hospital, Fitzroy, Victoria, Australia 5: Department of Infectious Diseases, Austin Health, Melbourne, Victoria, Australia 6: Centre for International Child Health, University of Melbourne Department of Paediatrics and Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Victoria, Australia 7: Nossal Institute for Global Health, University of Melbourne, Melbourne, Victoria, Australia 8: TB Control Unit, Department of Health Victoria, Melbourne, Victoria, Australia
Publication date: October 1, 2012
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