Coverage and yield of tuberculosis contact investigations in the Netherlands
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.
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: 01 December 2011
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