Risk Factors for Tuberculosis (TB) Among Household Contacts of Patients With Smear-Positive TB in 8 Provinces of Vietnam: A Nested Case-Control Study.

BACKGROUND: Tuberculosis (TB) continues to account for significant morbidity and mortality annually. Household contacts (HHCs) of persons with TB are a key population for targeting prevention and control interventions. We aimed to identify risk factors associated with developing TB among HHCs. METHODS: We conducted a nested case-control study among HHCs in 8 provinces in Vietnam enrolled in a randomized controlled trial of active case finding for TB. Cases were any HHCs diagnosed and registered with TB within the Vietnam National TB Program during 2 years of follow-up. Controls were selected by simple random sampling from the remaining HHCs. Risk factor data were collected at enrollment and during follow-up. A logistic regression model was developed to determine predictors of TB among HHCs. RESULTS: We selected 1254 HHCs for the analysis: 214 cases and 1040 controls. Underlying characteristics varied between both groups; cases were older, more likely to be male, with a higher proportion of reported previous TB and diabetes. Risk factors associated with a TB diagnosis included being male (adjusted odds ratio [aOR], 1.4; 95% confidence interval [CI], 1.03-2.0), residing in an urban setting (aOR, 1.8; 1.3-2.5), prior TB (aOR, 4.6; 2.5-8.7), history of diabetes (aOR, 3.1; 1.7-5.8), current smoking (aOR, 3.1; 2.2-4.4), and prolonged history of coughing in the index case at enrollment (OR , 1.6; 1.1-2.3). CONCLUSIONS: Household contacts remain an important key population for TB prevention and control. TB programs should ensure effective contact investigations are implemented for household contacts, particularly those with additional risk factors for developing TB.

Ultrathin binary grafted polymer layers with switchable morphology.

Polymer surface layers comprised of mixed chains grafted to a functionalized silicon surface with a total layer thickness of only 1-3 nm are shown to exhibit reversible switching of their structure. Carboxylic acid-terminated polystyrene (PS) and poly (butyl acrylate) (PBA) were chemically attached to a silicon surface that was modified with an epoxysilane self-assembled monolayer by a "grafting to" routine. While one-step grafting resulted in large, submicron microstructures, a refined, two-step sequential grafting procedure allowed for extremely small spatial dimensions of PS and PBA domains. By adjusting the grafting parameters, such as concentration of each phase and molecular weight, very finely structured surfaces resulted with roughly 10-nm phase domains and less than 0.5-nm roughness. Combining the glassy PS and the rubbery PBA, we implemented a design approach to fabricate a mixed brush from two immiscible polymers so that switching of the surface nanomechanical properties is possible. Post-grafting hydrolysis converted PBA to poly(acrylic acid) to amplify this switching in surface wettability. Preliminary tribological studies showed a difference in wear behavior of glassy and rubbery surface layers. Such switchable coatings have practical applications as surface modifications of complex nanoscale electronic devices and sensors, which is why we restricted total thickness for potential nanoscale gaps.