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Free Content Predictors of contact tracing completion and outcomes in tuberculosis: a 21-year retrospective cohort study

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SETTING:

Birmingham, UK, 1990–2010.

OBJECTIVE:

To identify predictors in contacts for completion of screening and of a positive screening outcome, i.e., a diagnosis of latent tuberculous infection (LTBI) or active tuberculosis (TB).

DESIGN:

A retrospective cohort study of TB notifications for a European city.

RESULTS:

A total of 46 158 contacts were identified from 7365 index cases. Over the study period 17 471 (40.9%) failed to complete screening. Active TB or LTBI was diagnosed in 2220 (7.0%) contacts of cases of pulmonary TB (PTB) and in 222 (2.7%) contacts of cases of extra-pulmonary TB (EPTB). The proportion of contacts offered LTBI treatment increased (P < 0.001) over the study period. Age, ethnicity, sex and use of interferon-gamma release assays (IGRA) were the most important predictors of screening completion, with working age adult males who were Black or from the Indian subcontinent least likely to complete. Age, smear positivity status of the index case and IGRA usage were the most important predictors of a positive screening outcome (active TB or LTBI diagnosed).

CONCLUSION:

Contact tracing of both PTB and EPTB index cases is useful for active case finding. The findings of this study can be used to target screening and improve the effectiveness and efficiency of local contact tracing programmes.
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Keywords: infectious disease reporting; interferon-gamma release tests; logistic regression; screening

Document Type: Research Article

Affiliations: 1: Department of Respiratory Medicine, The Royal Liverpool and Broadgreen University Hospitals, Liverpool, UK 2: Warwick Medical School, University of Warwick, Coventry, UK 3: Department of Intensive Care, Sandwell and West Birmingham Hospitals Trust, Birmingham, UK 4: Department of Infection & Tropical Medicine, Heart of England National Health Service Foundation Trust, Birmingham, UK

Publication date: June 1, 2014

More about this publication?
  • 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 lung health world-wide.

    To share scientific research of immediate concern as rapidly as possible, The Union is fast-tracking the publication of certain articles from the IJTLD and publishing them on The Union website, prior to their publication in the Journal. Read fast-track articles.

    Certain IJTLD articles are also selected for translation into French, Spanish, Chinese or Russian. These are available on the Union website.

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