Contact tracing: comparing the approaches for sexually transmitted diseases and tuberculosis

SETTING: Literature review for the process of contact tracing for sexually transmitted diseases (STD) and for tuberculosis (TB), focusing on articles that report results of studies or commentary.

OBJECTIVE: To compare and contrast contact tracing in order to highlight emerging commonalities.

DESIGN: A descriptive review, based on Medline search with augmentation from other published and unpublished sources.

RESULTS: Contact tracing for STD and TB have some obvious differences because of differing routes of transmission, differing sensibilities required to work with the affected populations, a different potential for anonymous contacts, and a major difference in the epidemiologic value of biomarkers. Nonetheless, the convergence of these processes on disadvantaged populations where drug use and sexual activity are important social factors has engendered an increasing similarity.

CONCLUSION: A broadened approach to both, with greater attention to how ancillary contacts and associates may be of use in interrupting deeply embedded endemic disease transmission, deserves further study. Some newer approaches in the use of network-informed methods to elicit contacts and investigate the community dynamics of transmission may be of particular value in TB case investigation. These strategies will be enhanced by the availability of DNA fingerprinting, a powerful biomarker of recent Mycobacterium tuberculosis transmission and case association (a technology not available for STD contact tracing).