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Free Content Coverage and yield of tuberculosis contact investigations in the Netherlands

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SETTING: An increasing proportion of tuberculosis (TB) patients in low-incidence countries are immigrants. It is unclear whether contact investigations among immigrant patients are adequate.

OBJECTIVE: To determine whether ethnicity of pulmonary TB patients was associated with coverage and yield of contact investigations in the Netherlands.

DESIGN: Contact investigation results were extracted from records of patients reported in the nationwide sur- veillance register in 2006 and 2007. Prevalence odds ra- tios (PORs) with 95% confidence intervals (CIs) were calculated to determine the association between patient ethnicity and coverage of contact investigations and the yield of individuals with Mycobacterium tuberculosisinfection or TB.

RESULTS: Of the 1040 pulmonary TB patients reported, 642 (62%) were eligible for analysis. Compared to close contacts of Dutch patients, close contacts of immigrant patients were significantly less likely to be examined for TB (89% vs. 93%, POR 0.6, 95%CI 0.5–0.7) and infec- tion (50% vs. 75%, POR 0.3, 95%CI 0.3–0.4), whereas the yield was significantly higher for disease (1.5% vs. 0.4%, POR 3.4, 95%CI 1.8–6.4) and infection (13% vs. 10%, POR 1.2, 95%CI 1.0–1.5).

CONCLUSION: The effectiveness of contact investiga- tions in the Netherlands can be optimised by expanding the investigation of contacts of immigrant patients.
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Keywords: CONTACT TRACING; EPIDEMIOLOGY; PREVENTION; SURVEILLANCE; TUBERCULOSIS

Document Type: Research Article

Affiliations: 1: KNCV Tuberculosis Foundation, The Hague, The Netherlands; Center for Infection and Immunity Amsterdam (CINIMA), Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands 2: Department of Tuberculosis Control, Public Health Service, Amsterdam, The Netherlands 3: Department of Tuberculosis Control, Public Health Service, The Hague, The Netherlands 4: KNCV Tuberculosis Foundation, The Hague, The Netherlands; Department of Tuberculosis Control, Public Health Service, Brabant Zuidoost, The Netherlands 5: KNCV Tuberculosis Foundation, The Hague, The Netherlands 6: Department of Infectious Diseases, Public Health Service, Amsterdam, The Netherlands; Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands 7: KNCV Tuberculosis Foundation, The Hague, The Netherlands; Department of Global Health, Academic Medical Center, Amsterdam Institute for Global Health and Development, Amsterdam, The Netherlands

Publication date: December 1, 2011

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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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