Open Access, Peer-reviewed
pISSN 2384-1079
eISSN 2384-1087
    Pediatr Infect Vaccine. 2015 Aug;22(2):91-96. Korean.
    Published online Aug 28, 2015.
    https://doi.org/10.14776/piv.2015.22.2.91
    Copyright © 2015 The Korean Society of Pediatric Infectious Diseases
    Original Article

    Outcomes of Child Contact Investigations of Active Pulmonary Tuberculosis Patients: A Single Center Experience from 2012 to 2014

    Taek-jin Lee,1 Eun-kyung Kim,2 and Hye-cheol Jeong2
      • 1Department of Pediatrics, CHA Bundang Medical Center, CHA University, Seongnam, Korea.
      • 2Department of Internal Medicine, CHA Bundang Medical Center, CHA University, Seongnam, Korea.
    • Corresponding author (Email: bjloveu@cha.ac.kr )
    Received April 08, 2015; Revised May 06, 2015; Accepted May 07, 2015.

    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 ≥5 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.

    Keywords
    Tuberculosis; Contact investigation; Child

    Figures

    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-resistant TB patients or parental refusal of treatment. TST indicates tuberculin skin test.

    Fig. 2
    Proportion of child contacts with positive tuberculin skin test (TST) results by bacteriologic status of index cases. AFB indicated acid-fast bacilli.

    Tables

    Table 1
    Multivariate Regression Model for Predictors of Child Contacts Who Were Incompletely Screened

    References

      1. Korea Centers for Disease Control and Prevention. Elimination of TB 2030. Seoul: Korea Centers for Disease Control and Prevention; 2008.
      1. Trunz BB, Fine P, Dye C. Effect of BCG vaccination on childhood tuberculous meningitis and miliary tuberculosis worldwide: a meta-analysis and assessment of cost-effectiveness. Lancet 2006;367:1173–1180.
      1. Centers for Disease Control and Prevention. Targeted tuberculin testing and treatment of latent tuberculosis infection. MMWR 2000;49(RR-6):1–51.
      1. Comstock GW, Livesay VT, Woolpert SF. The prognosis of a positive tuberculin reaction in childhood and adolescence. Am J Epidemiol 1974;99:131–138.
      1. Joint Committee for the Development of Korean Guidelines for Tuberculosis. Korean guidelines for tuberculosis. 1st ed. Seoul: Korea Centers for Disease Control and Prevention; 2011.
      1. Korea Centers for Disease Control and Prevention. National Guidelines for Control and Prevention of Tuberculosis. Seoul: Korea Centers for Disease Control and Prevention; 2015.
      1. Centers for Disease Control and Prevention. Essential components of a tuberculosis prevention and control program: recommendations of the Advisory Council for the Elimination of Tuberculosis. MMWR 1995;44(R-11):2.
      1. Marks SM, Taylor Z, Qualls NL, Shrestha-Kuwahara RJ, Wilce MA, Nguyen CH. Outcomes of contact investigations of infectious tuberculosis patients. Am J Respir Crit Care Med 2000;162:2033–2038.
      1. Reichler MR, Reves R, Bur S, Thompson V, Mangura BT, Ford J, et al. Evaluation of investigations conducted to detect and prevent transmission of tuberculosis. JAMA 2002;287:991–995.
      1. Fox GJ, Barry SE, Britton WJ, Marks GB. Contact investigation for tuberculosis: a systematic review and meta-analysis. Eur Respir J 2013;41:140–156.
      1. Veen J. Microepidemics of tuberculosis: the stone-in-the-pond principle. Tuber Lung Dis 1992;73:73–76.
      1. Huebner RE, Schein MF, Bass JB. The tuberculin skin test. Clin Infect Dis 1993;17:968–975.
      1. National Tuberculosis Controllers Association; Centers for Disease Control and Prevention (CDC). Guidelines for the investigation of contacts of persons with infectious tuberculosis. Recommendations from the National Tuberculosis Controllers Association and CDC. MMWR 2005;54(RR-15):1–47.
      1. Joint Tuberculosis Committee of the British Thoracic Society. Control and prevention of tuberculosis in the United Kingdom: code of practice 2000. Thorax 2000;55:887–901.
      1. Erkens CG, Kamphorst M, Abubakar I, Bothamley GH, Chemtob D, Haas W, et al. Tuberculosis contact investigation in low prevalence countries: a European consensus. Eur Respir J 2010;36:925–949.
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    MeSH Terms
    Child*
    Humans
    Male
    Mass Screening
    Medical Records
    Skin Tests
    Tuberculin
    Tuberculosis
    Tuberculosis, Pulmonary*
    Metrics
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