Infection and disease among household contacts of patients with multidrug-resistant tuberculosis
OBJECTIVE: To assess whether rates of infection and progression to active tuberculosis (TB) differed between household contacts of patients with multidrug-resistant (MDR) and drug susceptible (DS) pulmonary tuberculosis.
DESIGN: Household contacts were assessed for evidence of TB infection and disease by purified protein derivative (PPD) skin testing, physical examination, chest X-ray, and sputum smear and culture.
RESULTS: Among 133 close contacts of patients with MDR-TB, 44% were PPD-positive (≥10 mm) compared to 37% of 231 contacts of the DS-TB cases (P = 0.18, χ2 test, OR 1.2, 95%CI 0.8–2). In a multivariate logistic regression analysis, after allowance for between-household variation in PPD responses, PPD positivity among household contacts of patients with MDR-TB remained comparable to PPD positivity in contacts of patients with DS-TB (OR 2.1, 95%CI 0.7–6.5). Respectively six (4%) and 11 (4%) contacts of the MDR- and DS-TB cases were found to have active TB at the time of initial evaluation or during follow-up (P = 0.78, χ2 test). Five of six contacts of MDR-TB cases and nine of nine contacts of DS-TB cases who developed TB, and for whom drug susceptibility test results were available, had the same bacterial susceptibility profiles as their index cases. DNA fingerprinting analysis of Mycobacterium tuberculosis isolates was identical between household contacts with active TB and the index MDR or DS-TB case for all 14 pairs compared.
CONCLUSION: Our data suggest that the prevalence of tuberculous infection and progression to active TB among household contacts exposed to DS and MDR-TB cases is comparable, despite a longer duration of exposure of contacts to the index case in patients with MDR-TB.
Document Type: Regular Paper
Affiliations: 1: Núcleo de Doenças Infecciosas, Universidade Federal do Espírito Santo, Vitória, Brazil 2: Department of Medicine, Duke University Medical Center, Durham, North Carolina, USA 3: Department of Medicine, Division of Infectious Diseases, Case Western Reserve University, Cleveland, Ohio, USA 4: Department of Epidemiology and Biostatistics, Case Western Reserve University, Cleveland, Ohio, USA
Publication date: April 1, 2001
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
- Editorial Board
- Information for Authors
- Subscribe to this Title
- International Journal of Tuberculosis and Lung Disease
- Public Health Action
- Ingenta Connect is not responsible for the content or availability of external websites