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A prospective longitudinal study of tuberculosis among household contacts of smear-positive tuberculosis cases in Lima, Peru

Larissa Otero Vegas, Lena Shah, Kristien Verdonck, Tullia Battaglioli, Timothy Brewer, Eduardo Gotuzzo, Carlos Seas and Patrick Van Der Stuyft UGent (2016) BMC INFECTIOUS DISEASES. 16.
abstract
Background: Household contacts (HHCs) of TB cases are at increased risk for TB disease compared to the general population but the risk may be modified by individual or household factors. We conducted a study to determine incident TB among HHCs over two years after exposure and to identify individual and household level risk factors. Methods: Adults newly diagnosed with a first episode of smear-positive pulmonary TB (index cases) between March 2010 and December 2011 in eastern Lima, were interviewed to identify their HHC and household characteristics. TB registers were reviewed for up to two years after the index case diagnosis and house visits were made to ascertain TB cases among HHC. The TB incidence rate ratio among HHCs as a function of risk factors was determined using generalized linear mixed models. Results: The 1178 index cases reported 5466 HHCs. In 402/1178 (34.1 %) households, at least one HHC had experienced a TB episode ever. The TB incidence among HHCs was 1918 (95% CI 1669-2194) per 100,000 person-years overall, and was 2392 (95% CI 2005-2833) and 1435 (95% CI 1139-1787) per 100,000 person-years in the first and second year, respectively. Incident TB occurred more than six months following the index case's TB diagnosis in 121/205 (59.0 %) HHCs. In HHCs, bacillary load and time between symptoms and treatment initiation in the index case, as well as the relationship to the index case and the sex of the HHC all had a significant association with TB incidence in HHCs. Conclusions: Incidence of TB among HHCs was more than ten times higher than in the general population. Certain HHC and households were at higher risk of TB, we recommend studies to compare HHC investigation to households at highest risk versus current practice, in terms of efficiency.
Please use this url to cite or link to this publication:
author
organization
year
type
journalArticle (original)
publication status
published
subject
keyword
MULTIDRUG-RESISTANT TUBERCULOSIS, MIDDLE-INCOME COUNTRIES, PULMONARY, TUBERCULOSIS, METAANALYSIS, BURDEN, Multilevel analysis, Household contact investigation, Longitudinal study
journal title
BMC INFECTIOUS DISEASES
BMC Infect. Dis.
volume
16
article number
259
pages
8 pages
Web of Science type
Article
Web of Science id
000377946700001
JCR category
INFECTIOUS DISEASES
JCR impact factor
2.768 (2016)
JCR rank
37/84 (2016)
JCR quartile
2 (2016)
ISSN
1471-2334
DOI
10.1186/s12879-016-1616-x
language
English
UGent publication?
yes
classification
A1
copyright statement
Creative Commons Attribution 4.0 International Public License (CC-BY 4.0)
id
8510995
handle
http://hdl.handle.net/1854/LU-8510995
date created
2017-02-23 14:28:05
date last changed
2017-03-08 13:05:10
@article{8510995,
  abstract     = {Background: Household contacts (HHCs) of TB cases are at increased risk for TB disease compared to the general population but the risk may be modified by individual or household factors. We conducted a study to determine incident TB among HHCs over two years after exposure and to identify individual and household level risk factors. 
Methods: Adults newly diagnosed with a first episode of smear-positive pulmonary TB (index cases) between March 2010 and December 2011 in eastern Lima, were interviewed to identify their HHC and household characteristics. TB registers were reviewed for up to two years after the index case diagnosis and house visits were made to ascertain TB cases among HHC. The TB incidence rate ratio among HHCs as a function of risk factors was determined using generalized linear mixed models. 
Results: The 1178 index cases reported 5466 HHCs. In 402/1178 (34.1 \%) households, at least one HHC had experienced a TB episode ever. The TB incidence among HHCs was 1918 (95\% CI 1669-2194) per 100,000 person-years overall, and was 2392 (95\% CI 2005-2833) and 1435 (95\% CI 1139-1787) per 100,000 person-years in the first and second year, respectively. Incident TB occurred more than six months following the index case's TB diagnosis in 121/205 (59.0 \%) HHCs. In HHCs, bacillary load and time between symptoms and treatment initiation in the index case, as well as the relationship to the index case and the sex of the HHC all had a significant association with TB incidence in HHCs. 
Conclusions: Incidence of TB among HHCs was more than ten times higher than in the general population. Certain HHC and households were at higher risk of TB, we recommend studies to compare HHC investigation to households at highest risk versus current practice, in terms of efficiency.},
  articleno    = {259},
  author       = {Otero Vegas, Larissa and Shah, Lena and Verdonck, Kristien and Battaglioli, Tullia and Brewer, Timothy and Gotuzzo, Eduardo and Seas, Carlos and Van Der Stuyft, Patrick},
  issn         = {1471-2334},
  journal      = {BMC INFECTIOUS DISEASES},
  keyword      = {MULTIDRUG-RESISTANT TUBERCULOSIS,MIDDLE-INCOME COUNTRIES,PULMONARY,TUBERCULOSIS,METAANALYSIS,BURDEN,Multilevel analysis,Household contact investigation,Longitudinal study},
  language     = {eng},
  pages        = {8},
  title        = {A prospective longitudinal study of tuberculosis among household contacts of smear-positive tuberculosis cases in Lima, Peru},
  url          = {http://dx.doi.org/10.1186/s12879-016-1616-x},
  volume       = {16},
  year         = {2016},
}

Chicago
Otero Vegas, Larissa, Lena Shah, Kristien Verdonck, Tullia Battaglioli, Timothy Brewer, Eduardo Gotuzzo, Carlos Seas, and Patrick Van Der Stuyft. 2016. “A Prospective Longitudinal Study of Tuberculosis Among Household Contacts of Smear-positive Tuberculosis Cases in Lima, Peru.” Bmc Infectious Diseases 16.
APA
Otero Vegas, L., Shah, L., Verdonck, K., Battaglioli, T., Brewer, T., Gotuzzo, E., Seas, C., et al. (2016). A prospective longitudinal study of tuberculosis among household contacts of smear-positive tuberculosis cases in Lima, Peru. BMC INFECTIOUS DISEASES, 16.
Vancouver
1.
Otero Vegas L, Shah L, Verdonck K, Battaglioli T, Brewer T, Gotuzzo E, et al. A prospective longitudinal study of tuberculosis among household contacts of smear-positive tuberculosis cases in Lima, Peru. BMC INFECTIOUS DISEASES. 2016;16.
MLA
Otero Vegas, Larissa, Lena Shah, Kristien Verdonck, et al. “A Prospective Longitudinal Study of Tuberculosis Among Household Contacts of Smear-positive Tuberculosis Cases in Lima, Peru.” BMC INFECTIOUS DISEASES 16 (2016): n. pag. Print.