Yield of Systematic Longitudinal Screening of Household Contacts of Pre-Extensively Drug Resistant (PreXDR) and Extensively Drug Resistant (XDR) Tuberculosis Patients in Mumbai, India
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design
2.2. Setting
2.2.1. Household Contact (HHC) Investigation
2.2.2. Follow-Up of HHCs
2.3. Study Population and Participants
2.4. Data Variables and Sources, Data Analysis
2.5. Operational Definitions
2.6. Ethics
3. Results
3.1. TB Diagnosis among HHCs
3.2. Overall Yield of TB in HHCs
3.3. Drug Resistance Patterns
4. Discussion
4.1. Limitations
4.2. Implications for Policy and Practice
4.3. Implications for Future Research
5. Conclusions
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
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Characteristics | Groups | Index Cases | |
---|---|---|---|
N | % | ||
Type of TB drug resistance | Pre-Extensive Drug Resistance (pre-XDR) | 51 | (47) |
Extensive Drug Resistance (XDR) | 58 | (53) | |
Age at enrolment (years) | 0–14 | 9 | (8) |
15 and above | 100 | (92) | |
Sex | Male | 49 | (45) |
Female | 60 | (55) | |
Previous TB treatment | No treatment | 6 | (6) |
History of previous TB treatment | 103 | (94) | |
Site of TB in Index Case | Extra-pulmonary (EPTB) | 15 | (14) |
Pulmonary (PTB) | 94 | (86) | |
X-ray results (n = 105) | Abnormal | 92 | (88) |
Normal | 13 | (12) | |
Sputum conversion (in months) [Median (IQR)] (n = 76) | 2 (1–4) | ||
Human Immunodeficiency Virus (HIV) co-infection | 5 | (5) | |
Diabetes mellitus co-morbidity | 10 | (9) | |
Overcrowding (area per person <= 50 square feet) | 60 | (55) | |
Staying in rented house | 33 | (30) |
Variable | Household Contacts (n = 400) * | Household Contacts with Incident TB(n = 14) ** | p-Value | |
---|---|---|---|---|
Index Case Characteristics | n (%) | n (%) | ||
Type of index case | Pre-XDR | 166 (41) | 7 (4) | 0.51 |
XDR | 234 (59) | 7 (3) | ||
Age (Median(IQR), years) † | 24 (19–30) | 24 (18–26) | 0.43 | |
Sex | Male | 156 (39) | 6 (4) | 0.76 |
Female | 244 (61) | 8 (3) | ||
Prior TB treatment | No treatment | 23 (6) | 2 (9) | 0.43 |
TB treatment | 377 (94) | 12 (3) | ||
HIV in index case | No | 384 (96) | 12 (3) | 0.10 |
Yes | 16 (4) | 2 (13) | ||
AFB result | Negative | 183 (47) | 8 (4) | 0.59 |
Scanty | 42 (11) | 2 (5) | ||
Positive | 162 (42) | 4 (3) | ||
Site of TB | EPTB | 51 (13) | 0 (0) | |
PTB | 349 (87) | 14 (4) | ||
X-ray results | Abnormal | 344 (88) | 14 (4) | |
Normal | 47 (12) | 0 (0) | ||
Number of household contacts † | 6 (4–8) | 6 (5–10) | 0.21 | |
Household Contact Characteristics | ||||
Age group | 0–14 years | 94 (23) | 4 (4) | 0.75 |
15 years or more | 306 (97) | 10 (3) | ||
Sex | Male | 205 (51) | 6 (3) | 0.52 |
Female | 195 (49) | 8 (4) | ||
Relationship with index case | Child | 68 (17) | 3 (4) | 0.37 |
Parent | 120 (30) | 4 (3) | ||
Sibling | 97 (24) | 6 (6) | ||
Spouse | 22 (6) | 0 (0) | ||
Other | 93 (23) | 1 (1) | ||
Area < 50 sq/feet/capita | No | 226 (59) | 10 (4) | 0.32 |
Yes | 159 (41) | 4 (3) | ||
Past history of TB | No | 358 (90) | 11 (3) | 0.17 |
Yes | 42 (10) | 3 (7) |
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Paryani, R.H.; Gupta, V.; Singh, P.; Verma, M.; Sheikh, S.; Yadav, R.; Mansoor, H.; Kalon, S.; Selvaraju, S.; Das, M.; et al. Yield of Systematic Longitudinal Screening of Household Contacts of Pre-Extensively Drug Resistant (PreXDR) and Extensively Drug Resistant (XDR) Tuberculosis Patients in Mumbai, India. Trop. Med. Infect. Dis. 2020, 5, 83. https://doi.org/10.3390/tropicalmed5020083
Paryani RH, Gupta V, Singh P, Verma M, Sheikh S, Yadav R, Mansoor H, Kalon S, Selvaraju S, Das M, et al. Yield of Systematic Longitudinal Screening of Household Contacts of Pre-Extensively Drug Resistant (PreXDR) and Extensively Drug Resistant (XDR) Tuberculosis Patients in Mumbai, India. Tropical Medicine and Infectious Disease. 2020; 5(2):83. https://doi.org/10.3390/tropicalmed5020083
Chicago/Turabian StyleParyani, Roma Haresh, Vivek Gupta, Pramila Singh, Madhur Verma, Sabira Sheikh, Reeta Yadav, Homa Mansoor, Stobdan Kalon, Sriram Selvaraju, Mrinalini Das, and et al. 2020. "Yield of Systematic Longitudinal Screening of Household Contacts of Pre-Extensively Drug Resistant (PreXDR) and Extensively Drug Resistant (XDR) Tuberculosis Patients in Mumbai, India" Tropical Medicine and Infectious Disease 5, no. 2: 83. https://doi.org/10.3390/tropicalmed5020083