Tuberculosis contact tracing yield and associated factors in Uganda
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Date
2022-02-09
Journal Title
Journal ISSN
Volume Title
Publisher
BMC Pulmonary Medicine
Abstract
Background: The yield of tuberculosis (TB) contact tracing is historically low in Uganda. We determined factors asso ciated with a positive contact tracing yield at an urban public TB clinic in Kampala, Uganda.
Methods: We reviewed contact tracing registers of index TB cases registered between 2015 and 2020 at Kitebi
Health Center, a primary level facility. Contacts who had symptoms of TB were designated as having presumptive TB.
A contact investigation that yielded a new TB case was designated as a positive yield. We used logistic regression to
determine factors associated with a positive yield of contact tracing.
Results: Of 778 index TB cases, 455 (58.5%) had a contact investigation conducted. Index cases with a telephone
contact in the unit TB register (adjusted odds ratio (aOR) 1.66, 95% CI 1.02–1.97, p=0.036) were more likely to have a
contact investigation conducted than those who did not. Of 1350 contacts, 105 (7.8%) had presumptive TB. Of these,
73 (69.5%) were further evaluated for active TB and 29 contacts had active TB. The contact tracing yield for active TB
was therefore 2.1% (29/1,350). The odds of a positive yield increased tenfold with each additional presumptive contact
evaluated for active TB (aOR 10.1, 95% CI 2.95–34.66, p<0.001). Also, retreatment index TB cases were more likely to
yield a positive contact (aOR 7.69 95% CI 2.08–25.00, p=0.002) than to new cases.
Conclusion: TB contact tracing should aim to evaluate all contacts with presumptive TB and contacts of retreatment
cases to maximise the yield of contact tracing.
Description
Keywords
Contact tracing,, Tuberculosis,, Yield,, Presumptive,, Active,, Uganda
Citation
Baluku, J. B., Nabwana, M., Winters, M., & Bongomin, F. (2022). Tuberculosis contact tracing yield and associated factors in Uganda. BMC Pulmonary Medicine, 22(1), 1-7.