Background Understanding factors associated with prevalent Mycobacterium tuberculosis infection and prevalent TB disease in household contacts of patients with drug-resistant tuberculosis (TB) may be useful for TB program staff conducting contact investigations. Methods Using data from a cross-sectional study that enrolled index participants with rifampin-resistant pulmonary TB and their household contacts (HHCs), we evaluated HHCs age ≥15 years for factors associated with two outcomes: Mycobacterium tuberculosis infection and TB disease. Among HHCs who were not already diagnosed with current active TB disease by the TB program, Mycobacterium tuberculosis infection was determined by interferon-gamma release assay (IGRA). TB disease was adjudicated centrally. We fitted logistic regression models using generalized estimating equations. Results Seven hundred twelve HHCs age ≥15 years enrolled from 279 households in eight high-TB burden countries were a median age of 34 years, 63% female, 22% current smokers and 8% previous smokers, 8% HIV-positive, and 11% previously treated for TB. Of 686 with determinate IGRA results, 471 tested IGRA positive (prevalence 68.8% (95% Confidence Interval: 64.6%, 72.8%)). Multivariable modeling showed IGRA positivity was more common in HHCs aged 25–49 years; reporting prior TB treatment; reporting incarceration, substance use, and/or a period of daily alcohol use in the past 12 months; sharing a sleeping room or more evenings spent with the index participant; living with smokers; or living in a home of materials typical of low socioeconomic status. Forty-six (6.5% (95% Confidence Interval: 4.6%, 9.0%)) HHCs age ≥15 years had prevalent TB disease. Multivariable modeling showed higher prevalence of TB disease among HHCs aged ≥50 years; reporting current or previous smoking; reporting a period of daily alcohol use in the past 12 months; and reporting prior TB treatment. Conclusion We identified overlapping and distinct characteristics associated with Mycobacterium tuberculosis infection and TB disease that may be useful for those conducting household TB investigations.
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Soyeon Kim, Anneke C. Hesseling, Xingye Wu et al.. Factors associated with prevalent Mycobacterium tuberculosis infection and disease among adolescents and adults exposed to rifampin-resistant tuberculosis in the household. PLOS ONE. (2023). https://doi.org/10.1371/journal.pone.0283290 Soyeon Kim, Anneke C. Hesseling, Xingye Wu, Michael D. Hughes, N. Sarita Shah, Sanjay Gaikwad, Nishi Kumarasamy, Erika Mitchell, Mey Leon, Pedro Gonzales, Sharlaa Badal-Faesen, Madeleine Lourens, Sandy Nerette, Justin Shenje, Petra de Koker, Supalert Nedsuwan, Lerato Mohapi, Unoda A. Chakalisa, Rosie Mngqbisa, Rodrigo Otávio da Silva Escada, Samuel Ouma, Barbara Heckman, Linda Naini, Amita Gupta, Susan Swindells, Gavin Churchyard
1
Department of Biostatistics, Frontier Science Foundation, Brookline, Massachusetts, United States of America 2
Faculty of Medicine and Health Sciences, Department of Paediatrics and Child Health, Desmond Tutu TB Centre, Stellenbosch University, Cape Town, South Africa 3
Center for Biostatistics in AIDS Research, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America 4
Hubert Department of Global Health and Department of Epidemiology, Emory University Rollins School of Public Health, Atlanta, Georgia, United States of America 5
Byramjee Jeejeebhoy Government Medical College CRS and Sassoon General Hospital, BJMC Clinical Research Site, Pune, Maharashtra, India 6
Chennai Antiviral Research and Treatment (CART), Infectious Disease Medical Center, Voluntary Health Services, Chennai, India 7
Department of Medicine and University of Cape Town Lung Institute, Division of Pulmonology, University of Cape Town, Cape Town, South Africa 8
Barranco CRS, Asociación Civil Impacta Salud y Educación, Lima, Peru 9
San Miguel CRS, Asociación Civil Impacta Salud y Educación, Lima, Peru 10
University of the Witwatersrand CRS, University of the Witwatersrand, Johannesburg, South Africa 11
TASK Applied Science CRS, Brooklyn Chest Hospital, Bellville, South Africa 12
Institute of Infectious Diseases and Reproductive Health, Les Centres GHESKIO, Port-au-Prince, Haiti 13
South African Tuberculosis Vaccine Initiative, University of Cape Town, Cape Town, South Africa 14
PHPT-Chiangrai Prachanukroh Hospital, Chiang Rai, Thailand 15
Soweto CRS, Perinatal HIV Research Unit, University of the Witwatersrand, Johannesburg, South Africa 16
Gaborone CRS, Princess Marina Hospital, Gaborone, Botswana 17
Durban Adult HIV CRS, Enhancing Care Foundation, Durban University of Technology, Durban, South Africa 18
Instituto Nacional de Infectologia Evandro Chagas, Fiocruz, Brazil 19
Kenya Medical Research Institute, Kisumu, Kenya 20
Frontier Science Foundation, Amherst, New York, United States of America 21
Department of Clinical Research and Bioscience, Social & Scientific Systems, Silver Spring, Maryland, United States of America 22
Department of Medicine, Johns Hopkins University, Baltimore, Maryland, United States of America 23
Department of Internal Medicine, University of Nebraska Medical Center, Omaha, Nebraska, United States of America 24
Aurum Institute, Parktown, South Africa, School of Public Health, University of Witwatersrand, Johannesburg, South Africa, Vanderbilt University, Nashville, Tennessee, United States of America Rutgers Biomedical and Health Sciences, UNITED STATES EDITOR / REVIEWER
Selvakumar Subbian
