Magnitude of Mycobacterium tuberculosis transmission among household and non-household contacts of TB patients
- Authors
- Kato-Maeda, M.; Choi, J.C.; Jarlsberg, L.G.; Grinsdale, J.A.; Higashi, J.; Kawamura, L.M.; Osmond, D.H.; Hopewell, P.C.
- Issue Date
- Apr-2019
- Publisher
- International Union against Tubercul. and Lung Dis.
- Keywords
- contact investigation; risk factors
- Citation
- International Journal of Tuberculosis and Lung Disease, v.23, no.4, pp 433 - 440
- Pages
- 8
- Journal Title
- International Journal of Tuberculosis and Lung Disease
- Volume
- 23
- Number
- 4
- Start Page
- 433
- End Page
- 440
- URI
- https://scholarworks.bwise.kr/cau/handle/2019.sw.cau/33154
- DOI
- 10.5588/ijtld.18.0273
- ISSN
- 1027-3719
1815-7920
- Abstract
- SETTING: The household and non-household contacts of patients with tuberculosis (TB) face varying degrees of risk of infection by Mycobacterium tuberculosis. OBJECTIVE : To quantify new infection and to determine the risk factors associated with new infection among named contacts in San Francisco, CA, USA. DESIGN: We performed a cohort study in patients with culture-positive pulmonary TB. We analyzed patient, contact, environmental and bacterial characteristics. RESULTS : Of the 2422 contacts named by 256 patients, 149 (6.2%) had new infection due to recent transmission from 79 (30.9%) patients. Of the 149 new infections, 87 (58.4%) occurred among household contacts and 62 (41.6%) among non-household contacts. Numerous acid-fast bacilli in sputum (odds ratio [OR] 2.64, 95%CI 1.32-5.25) and contacts being named by more than one patient (OR 2.90, 95%CI 1.23-6.85) were associated with new infection among household contacts. Being older than 50 years (OR 1.93, 95%CI 1.09- 3.41) and an Asian/Pacific Islander (OR 3.09, 95%CI 1.50-6.37) were associated with new infection among non-household contacts. CONC L U S IONS : Fewer than one third of patients caused new infection to his/her contacts. A substantial proportion of transmission resulting in new infection occurred outside of the household. The risk factors for infection among household and non-household contacts are different and should be considered when prioritizing control interventions. © 2019 The Union.
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