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Free Content An evaluation of ‘Ribolola’: a household tuberculosis contact tracing programme in North West Province, South Africa

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SETTING: Rural/peri-urban community, South Africa.

OBJECTIVES: To examine the yield of tuberculosis (TB) cases, TB preventive therapy (TBPT) initiation and human immunodeficiency virus (HIV) diagnoses from household TB contact tracing.

DESIGN: Retrospective programme analysis.

METHODS: Households of index TB cases were visited and their contacts screened for TB and HIV. TB suspects provided sputum or were referred for assessment. Contacts aged <5 years were referred for assessment for TBPT initiation.

RESULTS: There were 732 index TB cases (67.1% HIV-positive). Among 3627 household contacts, 3573 (98.5%) had known outcomes, of which 183 (5.0%) were already on appropriate treatment. Among 3390 remaining contacts, 361 (10.6%) were aged <5 years, of whom 34 (9.4%) started anti-tuberculosis treatment and 286 (79.2%) started TBPT. Among 3029 contacts aged ≥5 years, 93 (3.1%) started anti-tuberculosis treatment: 19 (20.4%) were smear-positive and 71 (76.3%) were culture-positive. Among contacts aged ≥14 years, 794/2133 (37.2%) underwent HIV testing, of whom 208/794 (26.2%) tested positive.

CONCLUSIONS: Household active case finding in this high TB and HIV prevalence setting obtained high yields of TB, particularly in those aged <5 years, and facilitated assessment for TBPT. There was a good yield of new HIV diagnoses, and a gain in efficiency due to integration within one programme.
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Keywords: HIV; South Africa; case finding; tuberculosis

Document Type: Research Article

Affiliations: 1: London School of Hygiene & Tropical Medicine, London, UK 2: The Aurum Institute, Johannesburg, South Africa

Publication date: December 1, 2012

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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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