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Contact investigation for active tuberculosis among child contacts in Uganda

Devan Jaganath1, Sarah Zalwango, Brenda Okware

  • 1David Geffen School of Medicine at the University of California, Los Angeles.

Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America
|October 1, 2013
PubMed

Insights

Contact tracing in Uganda identified childhood tuberculosis cases early, preventing disease spread. Key risk factors included HIV, while BCG vaccination offered protection, guiding targeted screening efforts.

Area of Science:

  • Pediatric infectious diseases
  • Global health epidemiology
  • Public health interventions

Background:

  • Childhood tuberculosis (TB) remains a significant cause of illness and death globally.
  • Limited research exists on pediatric TB, especially in high-burden regions where contact tracing is underutilized.
  • This study addresses the need for better understanding of childhood TB and effective contact investigation strategies.

Purpose of the Study:

  • To evaluate the effectiveness of contact tracing in identifying childhood tuberculosis in a resource-limited setting.
  • To identify indicators of disease progression in child contacts of TB patients.
  • To inform targeted screening strategies for pediatric TB.

Main Methods:

  • A cohort of 761 child contacts (<15 years) in Kampala, Uganda, was followed for up to 24 months.
  • Tuberculosis diagnosis was based on clinical, radiographic, and laboratory assessments.
  • Isoniazid preventive therapy was administered to eligible children.

Main Results:

  • The prevalence of tuberculosis among child contacts was 10%, with 71% confirmed by culture.
  • Human immunodeficiency virus (HIV) infection and positive tuberculin skin tests were associated with increased TB risk (OR 7.90 and 2.21, respectively).
  • BCG vaccination significantly protected children, particularly those aged ≤5 years (OR 0.23).

Conclusions:

  • Contact tracing is effective in detecting culture-confirmed pediatric TB cases before dissemination in high-burden areas.
  • Identifying risk factors like HIV and protective factors like BCG vaccination aids in targeted screening and management.
  • This approach can help reduce morbidity and mortality associated with childhood tuberculosis.
Abstract

Keywords:
childcontact tracingpediatricrisk factorstuberculosis

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