Risk of active tuberculosis in adult household contacts of smear-positive pulmonary tuberculosis cases
OBJECTIVE: To investigate the risk of active TB among adult household contacts (age ≥ 15 years) of newly diagnosed sputum smear-positive pulmonary TB (PTB) cases in Istanbul.
DESIGN: A retrospective analysis of adult household contacts of 1570 pulmonary TB cases registered at seven TB dispensaries in Istanbul between 1997 and 2000.
RESULTS: A total of 6188 household contacts (mean contact/index case: 3.9) were included in the study, of whom 4114 (67%) were aged ≥15 years (mean contact/index case: 2.6); 3310 (80.5%) of these participated in a contact investigation. The mean duration of follow-up was 2.2 years (range 1–4 years); 222 active TB cases (rate 5.4%, 95%CI 5.2–5.6) were detected, 171 within the first year. The incidence of active TB was 2491/100 000 (3555/100 000 in the 15–34 year age group and 1195/100 000 in the ≥35 year age group, P < 0.0001). Rates of active TB were highest in the 15–24 year (8.5%) and 25–34 year (6.5%) age groups.
CONCLUSION: The incidence of active TB among adult household contacts of sputum smear-positive PTB cases was high. This high incidence justifies the prescription of chemopropylaxis not only for children but also for all contacts, especially those aged between 15 and 34 years.
Keywords: contact investigation; household contact; pulmonary tuberculosis; smear-positive cases
Document Type: Regular Paper
Affiliations: 1: Department of Respiratory Diseases, Istanbul Medical School, Istanbul University, Istanbul, Turkey 2: Sehremini Tuberculosis Dispensary, Istanbul, Turkey 3: Eyup Tuberculosis Dispensary, Istanbul, Turkey 4: Umraniye Tuberculosis Dispensary, Istanbul, Turkey 5: Besiktas Tuberculosis Dispensary, Istanbul, Turkey 6: Bagcilar Tuberculosis Dispensary, Istanbul, Turkey 7: Kadikoy Tuberculosis Dispensary, Istanbul, Turkey 8: Uskudar Tuberculosis Dispensary, Istanbul, Turkey
Publication date: 01 January 2009
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