Well-quantified tuberculosis exposure is a reliable surrogate measure of tuberculosis infection

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dc.contributor.authorMandalakas A.M.
dc.contributor.authorKirchner H.L.
dc.contributor.authorLombard C.
dc.contributor.authorWalzl G.
dc.contributor.authorGrewal H.M.S.
dc.contributor.authorGie R.P.
dc.contributor.authorHesseling A.C.
dc.date.accessioned2012-07-26T07:16:16Z
dc.date.available2012-07-26T07:16:16Z
dc.date.issued2012
dc.descriptionArticle
dc.description.abstractSETTING: Cape Town, South Africa. OBJECTIVE: To develop a standardized, reliable measure of household tuberculosis (TB) exposure that considers child-specific risk factors. DESIGN: We assessed TB exposure in 536 children. Children were considered Mycobacterium tuberculosis infected if two of three tests of infection were positive. Principal component analysis identified a discrete set of components that collectively described exposure and contributed to a composite contact score. Logistic regression assessed the odds of having M. tuberculosis infection given increasing contact score while controlling for age and past TB treatment. RESULTS: Four components described 68% of data variance: 1) maternal TB and sleep proximity, 2) index case infectivity, 3) duration of exposure, and 4) exposure to multiple index cases. Components were derived from 10 binary questions that contributed to a contact score (range 1-10, median 5, 25th-75th interquartile range [IQR] 4-7). Among children aged 3 months to 6 years with household exposure, the odds of being M. tuberculosis-infected increased by 74% (OR 1.74, 95%CI 1.42-2.12) with each 1-point increase in the contact score. CONCLUSIONS: Well-quantified TB exposure is a good surrogate measure of M. tuberculosis infection in child household contacts in a high-burden setting, and could guide targeted preventive treatment in children at highest risk of M. tuberculosis infection. © 2012 The Union.
dc.identifier.citationInternational Journal of Tuberculosis and Lung Disease
dc.identifier.citation16
dc.identifier.citation8
dc.identifier.citation1033
dc.identifier.citation1039
dc.identifier.issn10273719
dc.identifier.otherdoi:10.5588/ijtld.12.0027
dc.identifier.urihttp://hdl.handle.net/10019.1/21812
dc.subjectChildren
dc.subjectContact tracing
dc.subjectLatent tuberculosis infection
dc.subjectPediatrics
dc.subjectPreventive therapy
dc.titleWell-quantified tuberculosis exposure is a reliable surrogate measure of tuberculosis infection
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