RT Journal Article
SR Electronic
T1 Latent tuberculosis infection among contacts of patients with multidrug-resistant tuberculosis in New South Wales, Australia
JF ERJ Open Research
JO erjor
FD European Respiratory Society
SP 00149-2021
DO 10.1183/23120541.00149-2021
A1 Vicky Chang
A1 Raphael Hongxi Ling
A1 Kavindhran Velen
A1 Greg J. Fox
YR 2021
UL http://openres.ersjournals.com/content/early/2021/06/25/23120541.00149-2021.abstract
AB Background Contacts of an individual with active tuberculosis (TB) disease, have a higher risk of developing latent TB infection (LTBI) or active TB disease. Contact tracing is a public health measure that seeks to identify exposed contacts, screen them for co-prevalent TB, and consider prophylactic treatment to prevent progression from LTBI to active TB disease. The investigators sought to determine the prevalence of LTBI and active TB disease amongst MDR-TB contacts in New South Wales (NSW).Methodology A retrospective cohort study was performed among the contacts of patients diagnosed with MDR-TB between 2000 and 2016, inclusive, at seven chest clinics. Medical records were used to identify eligible contacts. Outcomes of screening and prophylactic treatment regimens offered to MDR-TB contacts with LTBI were characterised. Collected data included demographic information, screening tests results, and initial management.Results A total of 247 MDR-TB contacts of 55 MDR-TB patients were identified. LTBI was identified in 105 (42.5%) contacts. Preventive treatment was received by 20 (32.3%) contacts with LTBI, in the form of various regimens, ranging from one to three antimicrobials, with various doses and durations. One contacts with LTBI, untreated, were noted to have progressed to active TB disease during the study period, according to clinic notes.Conclusion Contacts of MDR-TB have a high prevalence of LTBI. Management of these contacts varies substantially in NSW, reflecting a lack of definitive evidence for preventive therapy. Further research is required to determine the optimal management of this population.FootnotesThis manuscript has recently been accepted for publication in the ERJ Open Research. It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJOR online. Please open or download the PDF to view this article.Conflict of interest: Dr. Chang has nothing to disclose.Conflict of interest: Dr. Ling has nothing to disclose.Conflict of interest: Dr. Velen has nothing to disclose.Conflict of interest: Dr. Fox has nothing to disclose.