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Free Content Tuberculosis incidence among contacts of active pulmonary tuberculosis

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BACKGROUND: Treatment of latent tuberculosis (TB) infection (LTBI) in Brazil is recommended only in the case of contacts of pulmonary smear-positive TB patients aged ≤15 years with a tuberculin skin test (TST) ≥ 10 mm and no previous bacille Calmette-Guérin (BCG) vaccination or with a TST ≥ 15 mm regardless of previous BCG vaccination.

OBJECTIVE: To evaluate the 2-year incidence and predictors of TB among contacts who did not meet the Brazilian criteria for LTBI treatment.

DESIGN: Retrospective cohort study. Contacts aged between 12 and 15 years and those aged ≥15 years who did not meet the Brazilian criteria for LTBI treatment were enrolled in the study.

RESULTS: TB incidence was 3.2% (22/667), with an estimated TB rate of 1649 per 100000 population. Risk of TB was greater among the 349 contacts with TST ≥ 5mm (5.4%) compared to the 318 contacts with TST < 5 mm (0.9%; RR 6.04, 95%CI 1.7–20.6).

CONCLUSION: The high incidence of TB among contacts who did not meet the Brazilian criteria for LTBI treatment strongly suggests that these criteria should be reviewed. Furthermore, even among BCG-vaccinated contacts, TST induration ≥5 mm was the only variable that predicted the development of TB disease within 2years.
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Keywords: LTBI; pulmonary tuberculosis; tuberculin test

Document Type: Regular Paper

Affiliations: 1: Instituto de Doenças do Torax, Hospital Clementino Fraga Filho da Universidade Federal do Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil 2: Faculdade de Medicina de Ribeirao Preto, Universidade de Sao Paulo, Sao Paolo, Brazil 3: Center for Tuberculosis Research, Johns Hopkins University, Baltimore, Maryland, USA

Publication date: 01 February 2009

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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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