Please use this identifier to cite or link to this item: https://www.arca.fiocruz.br/handle/icict/40291
Title: Feasibility of Identifying Household Contacts of Rifampin-and Multidrug-resistant Tuberculosis Cases at High Risk of Progression to Tuberculosis Disease
Authors: Gupta, Amita
Swindells, Susan
Kim, Soyeon
Hughes, Michael D.
Naini, Linda
Wu, Xingye
Dawson, Rodney
Mave, Vidya
Sanchez, Jorge
Mendoza, Alberto
Gonzales, Pedro
Kumarasamy, Nagalingeswaran
Comins, Kyla
Conradie, Francesca
Shenje, Justin
Fontain, Sandy Nerette
Garcia-Prats, Anthony
Asmelash, Aida
Nedsuwan, Supalert
Mohapi, Lerato
Lalloo, Umesh G.
Ferreira, Ana Cristina Garcia
Mugah, Christopher
Harrington, Mark
Jones, Lynne
Cox, Samyra R.
Smith, Betsy
Shah, N Sarita
Hesseling, Anneke C.
Churchyard, Gavin
Affilliation: Johns Hopkins University, Department of Medicine, Baltimore, Maryland./ Byramjee Jeejeebhoy Government Medical College, Johns Hopkins University Clinical Research Site, Pune, India.
University of Nebraska Medical Center, Omaha.
Frontier Science & Technology Research Foundation, Amherst, New York.
Harvard T. H. Chan School of Public Health, Boston, Massachusetts.
Social & Scientific Systems, Silver Spring, Maryland.
Harvard T. H. Chan School of Public Health, Boston, Massachusetts.
University of Cape Town Lung Institute and Department of Medicine, University of Cape Town, South Africa.
Johns Hopkins University, Department of Medicine, Baltimore, Maryland./ Byramjee Jeejeebhoy Government Medical College, Johns Hopkins University Clinical Research Site, Pune, India.
Asociación Civil Impacta Salud y Educación, Lima, Peru.
TASK Applied Science Clinical Research Site, Bellville, South Africa.
Asociación Civil Impacta Salud y Educación, Lima, Peru.
Chennai Antiviral Research and Treatment Clinical Research Site, India.
TASK Applied Science Clinical Research Site, Bellville.
University of the Witwatersrand Helen Joseph Hospital, Johannesburg, South Africa.
South African Tuberculosis Vaccine Initiative, Cape Town, South Africa.
GHESKIO Centers Institute of Infectious Diseases and Reproductive Health, Port-au-Prince, Haiti.
Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Stellenbosch University, Cape Town, South Africa.
Gaborone Clinical Research Site, Botswana.
PHPT-Changrai Prachanukroh Hospital, Chiang Rai, Thailand.
Soweto Clinical Research Site, University of the Witwatersrand, Johannesburg, South Africa.
Durban International Clinical Research Site, Durban University of Technology, South Africa.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Pesquisa Clínica em DST/AIDS. Rio de Janeiro, RJ, Brasil.
Kenya Medical Research Institute, Kisumu.
Treatment Action Group, New York, New York.
Frontier Science & Technology Research Foundation, Amherst, New York.
Johns Hopkins University, Department of Medicine, Baltimore, Maryland.
National Institutes of Health, Bethesda, Maryland.
US Centers for Disease Control and Prevention, Atlanta, Georgia.
Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Stellenbosch University, Cape Town, South Africa.
Aurum Institute, Parktown, South Africa./ University of Witwatersrand, School of Public Health./ Advancing Care and Treatment, South African Medical Research Council, Johannesburg, South Africa.
Abstract: Background. We assessed multidrug-resistant tuberculosis (MDR-TB) cases and their household contacts (HHCs) to inform the development of an interventional clinical trial. Methods. We conducted a cross-sectional study of adult MDR-TB cases and their HHCs in 8 countries with high TB burdens. HHCs underwent symptom screenings, chest radiographies, sputum TB bacteriologies, TB infection (TBI) testing (tuberculin skin test [TST] and interferon gamma release assay [IGRA]), and human immunodeficiency virus (HIV) testing. Results. From October 2015 to April 2016, 1016 HHCs from 284 MDR-TB cases were enrolled. At diagnosis, 69% of MDR-TB cases were positive for acid-fast bacilli sputum smears and 43% had cavitary disease; at study entry, 35% remained smear positive fter a median MDR-TB treatment duration of 8.8 weeks. There were 9 HHCs that were diagnosed with TB prior to entry and excluded. Of the remaining 1007 HHCs, 41% were male and the median age was 25 years. There were 121 (12%) HHCs that had new cases of TB identified: 17 (2%) were confirmed, 33 (3%) probable, and 71 (7%) possible TB cases. The TBI prevalence (defined as either TST or IGRA positivity) was 72% and varied by age, test used, and country. Of 1007 HHCs, 775 (77%) were considered high-risk per these mutually exclusive groups: 102 (10%) were aged <5 years; 63 (6%) were aged ≥5 and were infected with HIV; and 610 (61%) were aged ≥5 years, were negative for HIV or had an unknown HIV status, and were TBI positive. Only 21 (2%) HHCs were on preventive therapy. Conclusions. The majority of HHCs in these high-burden countries were at high risk of TB disease and infection, yet few were receiving routine preventive therapy. Trials of novel, preventive therapies are urgently needed to inform treatment policy and practice.
Keywords: TB disease
TB infection
Household contacts
Multidrug-resistant tuberculosis
Preventive therapy
Issue Date: 2020
Publisher: Oxford
Citation: GUPTA, Amita et al. Feasibility of Identifying Household Contacts of Rifampin-and Multidrug-resistant Tuberculosis Cases at High Risk of Progression to Tuberculosis Disease. Clinical infectious diseases, v. 70, n. 3, p. 425-435, 2020.
DOI: 10.1093/cid/ciz235
ISSN: 1058-4838
Copyright: restricted access
Appears in Collections:INI - Artigos de Periódicos

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