Related Experiment Video
Updated: Mar 8, 2026
A Tuberculosis Molecular Bacterial Load Assay TB-MBLA
Published on: April 30, 2020
Identifying children with tuberculosis among household contacts in The Gambia
1Vaccines and Immunity Theme, Medical Research Council (MRC) Unit-The Gambia, Banjul, The Gambia; Department of Epidemiology and Biostatistics, McGill University, Montreal, Quebec, Canada.
Insights
Contact tracing for tuberculosis (TB) in children needs to go beyond symptom screening and immediate households. Many co-prevalent TB cases in child contacts are missed with limited tracing strategies.
Area of Science:
- Infectious Diseases
- Public Health
- Pediatrics
Background:
- Tuberculosis (TB) remains a significant global health challenge, particularly affecting vulnerable populations like children.
- Identifying and treating TB in child contacts of infectious adults is crucial for disease control and prevention.
- Current contact tracing strategies may not be fully effective in detecting all cases among children.
Purpose of the Study:
- To determine the prevalence of co-prevalent tuberculosis (TB) among child contacts of adults diagnosed with smear-positive TB.
- To evaluate the effectiveness of symptom screening and tuberculin skin testing (TST) in identifying TB in child contacts.
- To assess the proportion of TB cases missed by limiting contact tracing to immediate households and symptom screening.
Main Methods:
- A prospective study enrolled child contacts (<15 years) of adults with smear-positive TB in the Greater Banjul Area, The Gambia.
- Children underwent symptom screening and tuberculin skin testing (TST).
- Symptomatic and/or TST-positive (≥10 mm) children were further investigated for TB disease.
Main Results:
- Out of 4042 child contacts, 64 (1.6%) had co-prevalent TB. Of these, 14 (21.9%) were from the compound, not the immediate household.
- Symptom screening alone would have missed 42.2% of co-prevalent TB cases.
- Children sleeping in the same bed as the index case represented 28.1% of all TB cases, highlighting close contact risks.
Conclusions:
- Relying solely on symptom screening and immediate household contact tracing significantly underestimates TB burden in child contacts.
- Expanded contact tracing strategies, including compound contacts and considering close sleeping arrangements, are essential for comprehensive TB case detection in children.
- Effective TB control requires a broader approach to identify all infected children within the extended household and community settings.
Setting:
Greater Banjul Area of the Gambia.
Objectives:
To identify co-prevalent tuberculosis (TB) among child contacts of adults with smear-positive TB.
Design:
Child contacts aged <15 years in the immediate household and compound were prospectively enrolled and evaluated for TB disease using screening questionnaires and the tuberculin skin test (TST). Symptomatic and/or TST-positive (10 mm) contacts were further investigated.
Results:
Of 4042 child contacts who underwent symptom screening and TST, 3339 (82.6%) were diagnosed as TB-exposed but not infected, 639 (15.8%) were latently infected and 64 (1.6%) had co-prevalent TB. Of the 64 TB cases, 50 (78.1%) were from within the immediate household of the index case, and 14 (21.9%) from within the same compound. Of the 27 asymptomatic but TST-positive children diagnosed with TB, 7 were microbiologically confirmed. The median age of the TB cases was 4.4 years (interquartile range 1.9-6.9); 53.1% were aged <5 years. Of the 4042 child contacts, 206 (5%) slept in the same bed as the index case; 28.1% of all TB cases occurred in this group. Symptom screening alone would have detected only 57.8% of the co-prevalent cases.
Conclusion:
In our community setting, if contact tracing is restricted to symptom screening and immediate households only, nearly half of all co-prevalent TB disease in child contacts would be missed.
More Related Videos
10:04Analysis of 18FDG PET/CT Imaging as a Tool for Studying Mycobacterium tuberculosis Infection and Treatment in Non-human Primates
Published on: September 5, 2017
09:02An Experimental Model to Study Tuberculosis-Malaria Coinfection upon Natural Transmission of Mycobacterium tuberculosis and Plasmodium berghei
Published on: February 17, 2014
Related Concept Videos
01:29Pulmonary Tuberculosis I
Causative Organism
The primary infectious agent causing tuberculosis is Mycobacterium tuberculosis, a slow-growing, acid-fast, aerobic rod that exhibits sensitivity to heat and ultraviolet light. Instances of Mycobacterium bovis and Mycobacterium avium contributing to the development of TB infection are rare.
Mode of...
01:28Pulmonary Tuberculosis V
Latent tuberculosis infection occurs when TB bacteria are present in a person's body, but are not causing illness or symptoms. It is not contagious, and preventive treatment is crucial to avoid the...
01:28Pulmonary Tuberculosis II
Here is a detailed explanation of its pathophysiology:
Transmission: The process begins when a person inhales droplet nuclei containing M. tuberculosis. These are typically released into the air when an individual with pulmonary or...
01:31Pulmonary Tuberculosis III
The first classification is based on the development of the disease, and it includes the following categories:
01:26Pulmonary Tuberculosis IV
Several diagnostic approaches are used to detect TB. The conventional method is the Tuberculin Skin Test (TST), also known as the Mantoux test. However, this method has...
01:17Transmission-based Precautions I: Contact, Enteric, and Droplets
Contact Precautions:
Contact precautions are the measures taken to prevent the transmission of infectious agents, especially epidemiologically important microorganisms such as MRSA or influenza, primarily transmitted through direct or indirect contact with an...