Feasibility of identifying household contacts of rifampin-and multidrug-resistant tuberculosis cases at high risk of progression to tuberculosis disease

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dc.contributor.authorGupta, Amitaen_ZA
dc.contributor.authorSwindells, Susanen_ZA
dc.contributor.authorKim, Soyeonen_ZA
dc.contributor.authorHughes, Michael D.en_ZA
dc.contributor.authorNaini, Lindaen_ZA
dc.contributor.authorWu, Xingyeen_ZA
dc.contributor.authorDawson, Rodneyen_ZA
dc.contributor.authorMave, Vidyaen_ZA
dc.contributor.authorSanchez, Jorgeen_ZA
dc.contributor.authorMendoza, Albertoen_ZA
dc.contributor.authorGonzales, Pedroen_ZA
dc.contributor.authorKumarasamy, Nagalingeswaranen_ZA
dc.contributor.authorComins, Kylaen_ZA
dc.contributor.authorConradie, Francescaen_ZA
dc.contributor.authorShenje, Justinen_ZA
dc.contributor.authorFontain, Sandy Neretteen_ZA
dc.contributor.authorGarcia-Prats, Anthonyen_ZA
dc.contributor.authorAsmelash, Aidaen_ZA
dc.contributor.authorNedsuwan, Supalerten_ZA
dc.contributor.authorMohapi, Leratoen_ZA
dc.contributor.authorLalloo, Umesh G.en_ZA
dc.contributor.authorFerreira, Ana Cristina Garciaen_ZA
dc.contributor.authorMugah, Christopheren_ZA
dc.contributor.authorHarrington, Marken_ZA
dc.contributor.authorJones, Lynneen_ZA
dc.contributor.authorCox, Samyra R.en_ZA
dc.contributor.authorSmith, Betsyen_ZA
dc.contributor.authorShah, N Saritaen_ZA
dc.contributor.authorHesseling, Anneke C.en_ZA
dc.contributor.authorChurchyard, Gavinen_ZA
dc.date.accessioned2022-06-02T13:09:23Zen_ZA
dc.date.available2022-06-02T13:09:23Zen_ZA
dc.date.issued2020-01en_ZA
dc.descriptionCITATION: Gupta, A. et al. 2020. Feasibility of identifying household contacts of rifampin-and multidrug-resistant tuberculosis cases at high risk of progression to tuberculosis disease. Clinical infectious diseases, 70(3): 425–435. doi:10.1093/cid/ciz235en_ZA
dc.descriptionThe original publication is available at https://academic.oup.com/cid/en_ZA
dc.description.abstractBackground: We assessed multidrug-resistant tuberculosis (MDR-TB) cases and their household contacts (HHCs) to inform the development of an interventional clinical trial. Methods: We conducted a cross-sectional study of adult MDR-TB cases and their HHCs in 8 countries with high TB burdens. HHCs underwent symptom screenings, chest radiographies, sputum TB bacteriologies, TB infection (TBI) testing (tuberculin skin test [TST] and interferon gamma release assay [IGRA]), and human immunodeficiency virus (HIV) testing. Results: From October 2015 to April 2016, 1016 HHCs from 284 MDR-TB cases were enrolled. At diagnosis, 69% of MDR-TB cases were positive for acid-fast bacilli sputum smears and 43% had cavitary disease; at study entry, 35% remained smear positive after a median MDR-TB treatment duration of 8.8 weeks. There were 9 HHCs that were diagnosed with TB prior to entry and excluded. Of the remaining 1007 HHCs, 41% were male and the median age was 25 years. There were 121 (12%) HHCs that had new cases of TB identified: 17 (2%) were confirmed, 33 (3%) probable, and 71 (7%) possible TB cases. The TBI prevalence (defined as either TST or IGRA positivity) was 72% and varied by age, test used, and country. Of 1007 HHCs, 775 (77%) were considered high-risk per these mutually exclusive groups: 102 (10%) were aged <5 years; 63 (6%) were aged ≥5 and were infected with HIV; and 610 (61%) were aged ≥5 years, were negative for HIV or had an unknown HIV status, and were TBI positive. Only 21 (2%) HHCs were on preventive therapy. Conclusions: The majority of HHCs in these high-burden countries were at high risk of TB disease and infection, yet few were receiving routine preventive therapy. Trials of novel, preventive therapies are urgently needed to inform treatment policy and practice.en_ZA
dc.description.urihttps://academic.oup.com/cid/article/70/3/425/5426963?login=trueen_ZA
dc.description.versionPublishers versionen_ZA
dc.format.extent11 pagesen_ZA
dc.identifier.citationGupta, A. et al. 2020. Feasibility of identifying household contacts of rifampin-and multidrug-resistant tuberculosis cases at high risk of progression to tuberculosis disease. Clinical infectious diseases, 70(3): 425–435. doi:10.1093/cid/ciz235en_ZA
dc.identifier.issn1537-6591 (online)en_ZA
dc.identifier.issn1058-4838 (print)en_ZA
dc.identifier.otherdoi:10.1093/cid/ciz235en_ZA
dc.identifier.urihttp://hdl.handle.net/10019.1/125306en_ZA
dc.language.isoen_ZAen_ZA
dc.publisherOxford University Pressen_ZA
dc.rights.holderAuthors retain copyrighten_ZA
dc.subjectMultidrug-resistant tuberculosisen_ZA
dc.subjectTuberculosis -- Diagnosisen_ZA
dc.subjectHousehold contactsen_ZA
dc.subjectMultidrug-resistant tuberculosisen_ZA
dc.subjectPreventive therapyen_ZA
dc.subjectRifampinen_ZA
dc.subjectMolecular diagnosisen_ZA
dc.titleFeasibility of identifying household contacts of rifampin-and multidrug-resistant tuberculosis cases at high risk of progression to tuberculosis diseaseen_ZA
dc.typeArticleen_ZA
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