Journal List > Pediatr Infect Vaccine > v.22(2) > 1096005

Lee, Kimz, and Jeong: Outcomes of Child Contact Investigations of Active Pulmonary Tuberculosis Patients: A Single Center Experience from 2012 to 2014

Abstract

Purpose

The study aimed to determine data collected during tuberculosis (TB) contact investigations and to evaluate the outcomes of these investigations.

Methods

We reviewed medical records for child contacts of patients with culture-positive pulmonary TB aged 19 years or older between August 2012 and July 2014.

Results

A total of 116 child contacts were identified for 79 patients with culture—positive pulmonary TB. of 116 contacts identified, 22% were incompletely screened. Of 90 contacts who completed screening, 42% had negative tuberculin skin test (TST) results, 58% had positive results, and 1% had active pulmonary TB at the time of investigation. Of 50 contacts with TB patients with a negative smear, 50% had positive TST results. Age 25 years (OR 8.3; 95% CI 2.3-30) and male gender (OR 3.9; 95% CI 1.5—9.9) were significantly associated with being incompletely screened.

Conclusions

Improvement is needed in the process of contact investigations to ensure that contacts of patients with active pulmonary TB are identified and appropriately screened.

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Fig. 1.
Flowchart of child contact investigations of infectious tuberculosis patients, Seongnam, Korea, 2012-2014. ∗There were 11 LTBI patients who were not offered treatment because of contact to multidrug—resistantTB patients or parental refusal of treatment. TST indi—cates tuberculin skin test.
piv-22-91f1.tif
Fig. 2.
Proportion of child contacts with positive tuberculin skin test (TST) results by bacteriologic status of index cases. AFB indicated acid-fast bacilli.
piv-22-91f2.tif
Table 1.
Multivariate Regression Model for Predictors of child contracts Who Were Incompletely Screened
Variable Child contacts who were incompletely screened N (%) Child contacts who completed screening N (%) Odds ratio (95% CI) P value
Age of contact, yr
  0-4 3(12) 49 (54) 1.0  
  5-17 23 (88) 41 (46) 8.3(2.3-30) 0.001
Gender of contact
  Male 18 (69) 33 (37) 3.9 (1.5-9.9) 0.005
  Female 8(31) 57 (63) 1.0  
Index case
  Parent 12 (46) 54 (60) 1.0  
  Non-parent 14(54) 36(40) 0.6(2.0-1.4) 0.212
Result of sputum smear
  Positive 15 (58) 4O (44) 1.7 (0.7-4.1) 0.236
  Negative 11 (42) 50 (56) 1.0  
Case disease Type
  New case 24 (92) 73 (81) 1.0  
  Retreatment case 2 (8) 17(19) 0.3 (0.1-1.7) 0.185
MDR∗ tuberculosis
  Yes 1 (4) 4 (4) 1.3(O.1-14) 0.808
  No 25 (96) 86 (96) 1.0  

MDR indicated multidrug-resistant.

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