Tuberculosis in household contacts of multidrug-resistant tuberculosis patients

Louis Grandjean, A. Crossa, R. H. Gilman, C. Herrera, C. Bonilla, O. Jave, J. L. Cabrera, L. Martin, A. R. Escombe, D. A.J. Moore

Research output: Contribution to journalArticlepeer-review

Abstract

SETTING: The burden of tuberculosis (TB) disease among household contacts of multidrug-resistant TB (MDR-TB) patients is poorly understood and might represent a target for transmission-interrupting interventions. DESIGN: This retrospective cohort study, conducted in Lima, Peru, from June to September 2008, estimated the incidence of TB disease among household contacts of MDR-TB patients in 358 households. RESULTS: Of 2112 household contacts in 80 households (22% of households), 108 (5%) developed TB disease during the study, giving an incidence rate of 2360 per 100 000 contact follow-up years for each of the fi rst 3 years after exposure. Drug susceptibility tests (DST) were available for 50 diseased contacts, of whom 36 (80%) had MDR-TB. Forty-two pairs of index-contact DSTs were available, among which the contact had an identical or less resistant phenotype than the index case in 27 pairs. Multivariate Cox regression demonstrated that male contacts (hazard ratio [HR] 2.8, P < 0.05), with previous TB disease (HR 20.7, P < 0.001) and with associated (non-human immunodefi ciency virus) comorbidities (HR 11.2, P < 0.001) were more likely to develop TB. CONCLUSION: The high percentage of diseased household contacts highlights an opportunity for householdlevel interventions to prevent transmission, whether or not these cases were all attributable to the index case.

Original languageEnglish (US)
Pages (from-to)1164-1169
Number of pages6
JournalInternational Journal of Tuberculosis and Lung Disease
Volume15
Issue number9
DOIs
StatePublished - Sep 1 2011

Keywords

  • Household contacts
  • Incidence
  • Multidrug-resistant
  • Tuberculosis

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Infectious Diseases

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