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Comparison of the yield of two tuberculosis screening approaches among household contacts in a community setting of Silti Zone, Central Ethiopia: a prospective cohort study.
Wolde, Habtamu Milkias; Zerihun, Betselot; Sinshaw, Waganeh; Yewhalaw, Delenasaw; Abebe, Gemeda.
Afiliação
  • Wolde HM; School of Medical Laboratory Sciences, Institute of Health, Jimma University, Jimma, Oromia, Ethiopia. habtamu.milkias@yahoo.com.
  • Zerihun B; Federal Ministry of Health, Addis Ababa, Ethiopia. habtamu.milkias@yahoo.com.
  • Sinshaw W; Ethiopian Public Health Institute, Addis Ababa, Ethiopia.
  • Yewhalaw D; Ethiopian Public Health Institute, Addis Ababa, Ethiopia.
  • Abebe G; School of Medical Laboratory Sciences, Institute of Health, Jimma University, Jimma, Oromia, Ethiopia.
BMC Pulm Med ; 24(1): 135, 2024 Mar 15.
Article em En | MEDLINE | ID: mdl-38491509
ABSTRACT

BACKGROUND:

Household contacts of tuberculosis (TB) patients are at a greater risk of infection and developing TB as well. Despite recommendations to actively screen such high-risk groups for TB, it is poorly implemented in Ethiopia. A community-based household contact screening was conducted to compare the yield of two different screening approaches and to identify factors associated with TB occurrence.

METHODS:

Smear-positive pulmonary TB index cases from six health facilities in six districts of Silti Zone were identified and enrolled prospectively between September 2020 and December 2022. Trained healthcare workers conducted house visits to screen household contacts for TB. WHO (World Health Organization) recommended symptom-based screening algorithms were used. The yield of screening was compared between a two-time screening at study site I and a single baseline screening at study site II, which is the current programmatic approach. Generalized estimating equation was used to run multivariate logistic regression to identify factors associated with TB occurrence.

RESULTS:

A total of 387 index TB cases (193 at site I and 194 at site II) with 1,276 eligible contacts were included for analysis. The TB yield of repeat screening approach did not show a significant difference compared to a single screening (2.3% at site I vs. 1.1% at site II, p < 0.072). The number needed to screen was 44 and 87 for the repeat and single screening, respectively, indicating a high TB burden in both settings. The screening algorithm for patients with comorbidities of asthma and heart failure had a 100% sensitivity, 19.1% specificity and a positive predictive value of 5.6%. Cough [AOR 10.9, 95%CI 2.55,46.37], fatigue [AOR 6.1, 95%CI 1.76,21.29], daily duration of contact with index case [AOR 4.6, 95%CI; 1.57,13.43] and age of index cases [AOR 0.9, 95%CI; 0.91-0.99] were associated with the occurrence of TB among household contacts.

CONCLUSION:

Our study showed that the yield of TB was not significantly different between one-time screening and repeat screening. Although repeat screening has made an addition to case notification, it should be practiced only if resources permit. Cough, fatigue, duration of contact and age of index cases were factors associated with TB. Further studies are needed to establish the association between older age and the risk of transmitting TB.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Tuberculose / Busca de Comunicante Limite: Humans País/Região como assunto: Africa Idioma: En Revista: BMC Pulm Med Ano de publicação: 2024 Tipo de documento: Article País de afiliação: Etiópia País de publicação: Reino Unido

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Tuberculose / Busca de Comunicante Limite: Humans País/Região como assunto: Africa Idioma: En Revista: BMC Pulm Med Ano de publicação: 2024 Tipo de documento: Article País de afiliação: Etiópia País de publicação: Reino Unido