Delayed tuberculosis diagnosis and tuberculosis transmission

Jonathan E Golub, S. Bur, W. A. Cronin, Stephen J Gange, N. Baruch, G. W. Comstock, Richard E Chaisson

Research output: Contribution to journalArticle

Abstract

SETTING: Tuberculosis (TB) patients and their close contacts reported to the Maryland Department of Health and Mental Hygiene from 1 June 2000 to 30 November 2001. OBJECTIVES: A recent prospective study found that 49% of pulmonary TB patients had total treatment delays ≥90 days. This cohort was analyzed to determine the association between total treatment delay and TB transmission. DESIGN: TB patient data were collected as part of a prospective cohort study; contact data were collected from local health departments. RESULTS: Close contacts of 54 US-born patients (n = 310) and those of 70 foreign-born cases (n = 393) received tuberculin skin tests (TSTs). Among contacts of US-born patients with a total treatment delay of ≥90 days, 40% had positive TSTs vs. 24% contacts of patients with shorter delays (aOR 2.34; P = 0.03). Other patient factors associated with TST positivity among contacts of US-born cases were black race (aOR 3.03; P = 0.05), sputum smear positive for AFB (aOR 3.29; P = 0.01) and chest radiograph with cavitation (aOR 3.11; P = 0.01). No associations were observed between foreign-born patients and risk of TST positivity among their contacts. CONCLUSION: Among US-born patients, delay in TB diagnosis is associated with greater transmission of infection to contacts and could be used independently of other index patient factors to identify contacts at greatest risk of TB infection.

Original languageEnglish (US)
Pages (from-to)24-30
Number of pages7
JournalInternational Journal of Tuberculosis and Lung Disease
Volume10
Issue number1
StatePublished - Jan 2006

Fingerprint

Delayed Diagnosis
Tuberculosis
Tuberculin Test
Skin Tests
Prospective Studies
Infectious Disease Transmission
Health
Sputum
Pulmonary Tuberculosis
Mental Health
Cohort Studies
Thorax
Therapeutics

Keywords

  • Delayed diagnosis
  • Transmission
  • Tuberculosis

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

Cite this

Delayed tuberculosis diagnosis and tuberculosis transmission. / Golub, Jonathan E; Bur, S.; Cronin, W. A.; Gange, Stephen J; Baruch, N.; Comstock, G. W.; Chaisson, Richard E.

In: International Journal of Tuberculosis and Lung Disease, Vol. 10, No. 1, 01.2006, p. 24-30.

Research output: Contribution to journalArticle

@article{b9bfe210a8ff48478a008809f7679751,
title = "Delayed tuberculosis diagnosis and tuberculosis transmission",
abstract = "SETTING: Tuberculosis (TB) patients and their close contacts reported to the Maryland Department of Health and Mental Hygiene from 1 June 2000 to 30 November 2001. OBJECTIVES: A recent prospective study found that 49{\%} of pulmonary TB patients had total treatment delays ≥90 days. This cohort was analyzed to determine the association between total treatment delay and TB transmission. DESIGN: TB patient data were collected as part of a prospective cohort study; contact data were collected from local health departments. RESULTS: Close contacts of 54 US-born patients (n = 310) and those of 70 foreign-born cases (n = 393) received tuberculin skin tests (TSTs). Among contacts of US-born patients with a total treatment delay of ≥90 days, 40{\%} had positive TSTs vs. 24{\%} contacts of patients with shorter delays (aOR 2.34; P = 0.03). Other patient factors associated with TST positivity among contacts of US-born cases were black race (aOR 3.03; P = 0.05), sputum smear positive for AFB (aOR 3.29; P = 0.01) and chest radiograph with cavitation (aOR 3.11; P = 0.01). No associations were observed between foreign-born patients and risk of TST positivity among their contacts. CONCLUSION: Among US-born patients, delay in TB diagnosis is associated with greater transmission of infection to contacts and could be used independently of other index patient factors to identify contacts at greatest risk of TB infection.",
keywords = "Delayed diagnosis, Transmission, Tuberculosis",
author = "Golub, {Jonathan E} and S. Bur and Cronin, {W. A.} and Gange, {Stephen J} and N. Baruch and Comstock, {G. W.} and Chaisson, {Richard E}",
year = "2006",
month = "1",
language = "English (US)",
volume = "10",
pages = "24--30",
journal = "International Journal of Tuberculosis and Lung Disease",
issn = "1027-3719",
publisher = "International Union against Tubercul. and Lung Dis.",
number = "1",

}

TY - JOUR

T1 - Delayed tuberculosis diagnosis and tuberculosis transmission

AU - Golub, Jonathan E

AU - Bur, S.

AU - Cronin, W. A.

AU - Gange, Stephen J

AU - Baruch, N.

AU - Comstock, G. W.

AU - Chaisson, Richard E

PY - 2006/1

Y1 - 2006/1

N2 - SETTING: Tuberculosis (TB) patients and their close contacts reported to the Maryland Department of Health and Mental Hygiene from 1 June 2000 to 30 November 2001. OBJECTIVES: A recent prospective study found that 49% of pulmonary TB patients had total treatment delays ≥90 days. This cohort was analyzed to determine the association between total treatment delay and TB transmission. DESIGN: TB patient data were collected as part of a prospective cohort study; contact data were collected from local health departments. RESULTS: Close contacts of 54 US-born patients (n = 310) and those of 70 foreign-born cases (n = 393) received tuberculin skin tests (TSTs). Among contacts of US-born patients with a total treatment delay of ≥90 days, 40% had positive TSTs vs. 24% contacts of patients with shorter delays (aOR 2.34; P = 0.03). Other patient factors associated with TST positivity among contacts of US-born cases were black race (aOR 3.03; P = 0.05), sputum smear positive for AFB (aOR 3.29; P = 0.01) and chest radiograph with cavitation (aOR 3.11; P = 0.01). No associations were observed between foreign-born patients and risk of TST positivity among their contacts. CONCLUSION: Among US-born patients, delay in TB diagnosis is associated with greater transmission of infection to contacts and could be used independently of other index patient factors to identify contacts at greatest risk of TB infection.

AB - SETTING: Tuberculosis (TB) patients and their close contacts reported to the Maryland Department of Health and Mental Hygiene from 1 June 2000 to 30 November 2001. OBJECTIVES: A recent prospective study found that 49% of pulmonary TB patients had total treatment delays ≥90 days. This cohort was analyzed to determine the association between total treatment delay and TB transmission. DESIGN: TB patient data were collected as part of a prospective cohort study; contact data were collected from local health departments. RESULTS: Close contacts of 54 US-born patients (n = 310) and those of 70 foreign-born cases (n = 393) received tuberculin skin tests (TSTs). Among contacts of US-born patients with a total treatment delay of ≥90 days, 40% had positive TSTs vs. 24% contacts of patients with shorter delays (aOR 2.34; P = 0.03). Other patient factors associated with TST positivity among contacts of US-born cases were black race (aOR 3.03; P = 0.05), sputum smear positive for AFB (aOR 3.29; P = 0.01) and chest radiograph with cavitation (aOR 3.11; P = 0.01). No associations were observed between foreign-born patients and risk of TST positivity among their contacts. CONCLUSION: Among US-born patients, delay in TB diagnosis is associated with greater transmission of infection to contacts and could be used independently of other index patient factors to identify contacts at greatest risk of TB infection.

KW - Delayed diagnosis

KW - Transmission

KW - Tuberculosis

UR - http://www.scopus.com/inward/record.url?scp=33144463303&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=33144463303&partnerID=8YFLogxK

M3 - Article

C2 - 16466033

AN - SCOPUS:33144463303

VL - 10

SP - 24

EP - 30

JO - International Journal of Tuberculosis and Lung Disease

JF - International Journal of Tuberculosis and Lung Disease

SN - 1027-3719

IS - 1

ER -