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[Large-scale outbreak investigation for tuberculosis in Zeist]
J V Kuyvenhoven1, F G J Cobelens
1KNCV Tuberculosefonds, Postbus 146, 2501 CC Den Haag.
Nederlands Tijdschrift Voor Geneeskunde
|September 15, 2005
Summary
A large supermarket tuberculosis investigation found only 3% recent infections among 14,000 tested. The study questions the cost-effectiveness of widespread contact tracing for low-risk individuals in low-prevalence settings.
Area of Science:
- Public Health
- Epidemiology
- Infectious Disease Control
Context:
- A large-scale tuberculosis outbreak investigation was conducted among supermarket customers in Zeist, Netherlands.
- An employee diagnosed with smear-positive pulmonary tuberculosis prompted the investigation.
- The study involved tuberculin skin testing (TST) and chest X-rays for approximately 20,000 individuals.
Purpose:
- To assess the effectiveness and cost-benefit of large-scale contact tracing for tuberculosis in a low-prevalence country.
- To evaluate the yield of active tuberculosis cases and recent infections from widespread screening.
- To inform public health strategies for tuberculosis control in similar settings.
Summary:
- Out of 14,000 individuals tested with TST, around 400 showed positive results.
- Eight cases of active tuberculosis were identified.
- The estimated prevalence of recent infections among sporadic contacts was low, approximately 3%.
Impact:
- The findings highlight the need to balance the benefits of early case detection against the significant costs and potential for false positives in large-scale screening operations.
- Results suggest that extensive contact investigations for sporadic cases in low-prevalence settings may have limited public health utility.
- This study contributes to the ongoing discussion on optimizing tuberculosis control strategies, particularly contact tracing, in resource-limited or low-incidence environments.