Tuberculosis contact tracing yield and associated factors in Uganda

Area of Science:

• Public Health
• Infectious Disease Epidemiology
• Tuberculosis Control

Background:

• Tuberculosis (TB) contact tracing in Uganda faces challenges with historically low yields.
• Identifying factors associated with a positive yield is crucial for improving TB control efforts.

Purpose of the Study:

• To determine factors associated with a positive contact tracing yield.
• To enhance the effectiveness of TB contact tracing in an urban public clinic in Kampala, Uganda.

Main Methods:

• Retrospective review of contact tracing registers from 2015-2020 at Kitebi Health Center.
• Logistic regression analysis to identify predictors of positive contact tracing yield.
• Definition of presumptive TB for symptomatic contacts and positive yield for identified active TB cases.

Main Results:

• A contact investigation was conducted for 58.5% of 778 index TB cases.
• The overall contact tracing yield for active TB was 2.1% (29 out of 1350 contacts).
• Evaluating additional presumptive TB contacts (aOR 10.1) and investigating contacts of retreatment TB cases (aOR 7.69) significantly increased the odds of a positive yield.

Conclusions:

• Contact tracing efforts should prioritize evaluating all contacts with presumptive TB.
• Focusing on contacts of retreatment TB cases is essential for maximizing yield.
• These targeted strategies can improve the efficiency and effectiveness of TB contact tracing programs.