The impact of drug resistance on the risk of tuberculosis infection and disease in child household contacts : a cross sectional study

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dc.contributor.authorGolla, Veraen_ZA
dc.contributor.authorSnow, Kathrynen_ZA
dc.contributor.authorMandalakas, Anna M.en_ZA
dc.contributor.authorSchaaf, Simon H.en_ZA
dc.contributor.authorDu Preez, Karenen_ZA
dc.contributor.authorHesseling, Anneke C.en_ZA
dc.contributor.authorSeddon, James A.en_ZA
dc.date.accessioned2017-09-04T06:29:11Z
dc.date.available2017-09-04T06:29:11Z
dc.date.issued2017-08-29
dc.date.updated2017-09-03T03:28:31Z
dc.descriptionCITATION: Golla, V., et al. 2017. The impact of drug resistance on the risk of tuberculosis infection and disease in child household contacts : a cross sectional study. BMC Infectious Diseases, 17:593, doi:10.1186/s12879-017-2668-2.
dc.descriptionThe original publication is available at https://bmcinfectdis.biomedcentral.com
dc.description.abstractENGLISH SUMMARY : Background: The relative fitness of organisms causing drug-susceptible (DS) and multidrug-resistant (MDR) tuberculosis (TB) is unclear. We compared the risk of TB infection and TB disease in young child household contacts of adults with confirmed DS-TB and MDR-TB. Methods: In this cross-sectional analysis we included data from two community-based contact cohort investigation studies conducted in parallel in Cape Town, South Africa. Children <5 years of age with household exposure to an infectious TB case were included between August 2008 to June 2011. Children completed investigation for TB infection (tuberculin skin test) and TB disease (symptom evaluation, chest radiograph, bacteriology) in both studies using standard approaches. The impact of MDR-TB exposure on each covariate of TB infection and TB disease was assessed using univariable and multivariable logistic regression. Results: Of 538 children included, 312 had DS-TB and 226 had MDR-TB exposure. 107 children with DS-TB exposure had TB infection (34.3%) vs. 101 (44.7%) of children with MDR-TB exposure (adjusted Odds Ratio [aOR]: 2.05; 95% confidence interval [CI]: 1.34–3.12). A total of 15 (6.6%) MDR-TB vs. 27 (8.7%) DS-TB child contacts had TB disease at enrolment (aOR: 0.43; 95% CI: 0.19–0.97). Conclusions: Our results suggest a higher risk of TB infection in child contacts with household MDR-TB vs. DS-TB exposure, but a lower risk of TB disease. Although potentially affected by residual confounding or selection bias, our results are consistent with the hypothesis of impaired virulence in MDR-TB strains in this setting.
dc.description.urihttps://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-017-2668-2
dc.description.versionPublisher's version
dc.format.extent10 pages ; illustrations
dc.identifier.citationGolla, V., et al. 2017. The impact of drug resistance on the risk of tuberculosis infection and disease in child household contacts : a cross sectional study. BMC Infectious Diseases, 17:593, doi:10.1186/s12879-017-2668-2
dc.identifier.issn1471-2334 (online)
dc.identifier.otherdoi:10.1186/s12879-017-2668-2
dc.identifier.urihttp://hdl.handle.net/10019.1/102166
dc.language.isoen_ZA
dc.publisherBiomed Central
dc.rights.holderAuthors retain copyright
dc.subjectTuberculosis -- Preschool children -- Cape Town (South Africa)en_ZA
dc.subjectDrug resistanceen_ZA
dc.subjectMycobacterium tuberculosis -- Preschool children -- Cape Town (South Africa)en_ZA
dc.titleThe impact of drug resistance on the risk of tuberculosis infection and disease in child household contacts : a cross sectional studyen_ZA
dc.typeArticleen_ZA
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