Prospective cohort study of the feasibility and yield of household child tuberculosis contact screening in Uganda.

Authors: Bonnet M Kyakwera C Kyomugasho N Atwine D Mugabe F Nansumba M Ii YB Mwanga-Amumpaire J Kiwanuka J
Journal Reference: The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease 2017 08 01; 21(8); 862-868. doi: 10.5588/ijtld.16.0889. Epub 2018 04 26
eng

Abstract

SETTING: Screening and isoniazid preventive therapy (IPT) of child contacts of tuberculosis (TB) patients is poorly implemented in resource-limited countries, in part due to difficulties in TB diagnosis in children.

OBJECTIVE: To assess the feasibility and yield of hospital-based screening and IPT in Uganda, and to evaluate the utility of symptom-based screening.

DESIGN: Household child (age

RESULTS: Of 281 contacts (median age 33 months), 44 (15.7%) started anti-tuberculosis treatment and 234 (83.3%) received IPT, 80.3% of whom completed a 6-month course. After adjustment for age and human immunodeficiency virus status, cough (aOR 4.10, 95%CI 1.39-12.11) and reduced playfulness (aOR 7.79, 95%CI 2.12-25.18) were associated with radiological TB. Screening based on cough or reduced playfulness had a sensitivity of 81.8% and a negative predictive value of 97.6%.

CONCLUSION: Hospital-based screening appears to be feasible, and confirms the potential utility of symptom-based screening to select children for IPT and those for further investigations.