Skip to main content
padlock icon - secure page this page is secure

Free Content Is TB contact screening relevant in a developing country setting? Experiences from eastern Nepal, 1996–1998

Download Article:
(PDF 107.7 kb)
SETTING: A tuberculosis programme run by a non-governmental organisation in eight hill and mountain districts of eastern Nepal.

OBJECTIVE: To assess the impact of contact screening on case-finding.

DESIGN: A retrospective cohort study of contacts of smear-positive, smear-negative and extra-pulmonary tuberculosis patients diagnosed and registered during 1996–1998 (‘index cases’). Contacts, defined as household members identified by index cases, were screened by sputum examination; two positive smears were taken to indicate smear-positive pulmonary disease.

RESULTS: Approximately 50% (668) of registered cases identified contacts; 75% (2298) of the contacts identified provided one or more sputum specimens. An overall smear-positive case yield of 0.61% (14) was obtained from contacts tested, all except one of which were contacts of smear-positive index cases. For smear-positive index cases with a smear grading of ≥2+, the yield was 7.2 times greater (P = 0.04) than for those with a grading of 1+.

CONCLUSION: In this setting, sputum examination of household contacts of smear-negative and extra-pulmonary tuberculosis cases is not justified. Further assessment is needed to evaluate the utility of testing contacts of smear-positive cases without symptom screening, and whether cost effectiveness can be improved by restricting testing to contacts of cases with high bacterial (≥2+) loads.
No Reference information available - sign in for access.
No Supplementary Data.
No Article Media
No Metrics

Keywords: Nepal; contact screening; developing country; tuberculosis

Document Type: Regular Paper

Affiliations: 1: The Britain-Nepal Medical Trust, Biratnagar, Nepal 2: Eastern Mediterranean Region Office, World Health Organisation, Alexandria, Egypt

Publication date: October 1, 2000

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.

  • 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
  • Access Key
  • Free content
  • Partial Free content
  • New content
  • Open access content
  • Partial Open access content
  • Subscribed content
  • Partial Subscribed content
  • Free trial content
Cookie Policy
Cookie Policy
Ingenta Connect website makes use of cookies so as to keep track of data that you have filled in. I am Happy with this Find out more