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Free Content Risk factors for Mycobacterium tuberculosis infection in Indonesian children living with a sputum smear-positive case

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Abstract:

SETTING AND OBJECTIVES: Young children living with infectious tuberculosis (TB) cases are at high risk of infection and disease, and screening is recommended. This is rarely conducted in resource-limited settings. Identifying children most at risk of infection may be useful for setting practical screening policies.

DESIGN: Child contacts of smear-positive adult TB patients were invited for Mycobacterium tuberculosis infection and disease screening by symptoms, tuberculin skin test (TST), QuantiFERON®-TB Gold In-Tube assay (QFT-GIT) and chest X-ray. Risk factors for infection were collected using a questionnaire and were calculated separately for TST, for QFT-GIT and for both tests combined.

RESULTS: Of 304 screened children 145/302 (48%) were positive using TST, 152/299 (51%) by QFT-GIT and 180/304 (59%) were positive using either or both tests. Positivity for both tests was associated with index case infectivity (acid-fast bacilli [AFB] 3+ vs. AFB 1+: TST OR 2.93, 95%CI 1.59–5.39; QFT-GIT OR 2.28, 95%CI 1.06–4.90) and exposure (child contact's parent is the index case: TST OR 7.04, 95%CI 2.23–22.28; QFT-GIT OR 4.30, 95%CI 1.48–12.45).

CONCLUSION: M. tuberculosis infection according to either test was high, supporting screening and preventive treatment. Children of smear-positive TB cases who accompany their parents to the clinic should be prioritised for immediate screening.

Keywords: QuantiFERON-TB Gold In-Tube assay; child contacts; tuberculin skin test

Document Type: Research Article

DOI: https://doi.org/10.5588/ijtld.12.0389

Affiliations: 1: Centre for International Health, University of Otago, Dunedin, New Zealand 2: Health Research Unit, Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia 3: Bandung Community Lung Clinic, Bandung, Indonesia 4: Department of Medicine, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands

Publication date: 2012-12-01

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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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