Contact Investigation in Households of Patients with Tuberculosis in Hanoi,Vietnam: A Prospective Cohort Study |
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Authors: | Gregory James Fox Nguyen Viet Nhung Dinh Ngoc Sy Luu Thi Lien Nguyen Kim Cuong Warwick John Britton Guy Barrington Marks |
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Affiliation: | 1. Woolcock Institute of Medical Research, Sydney, New South Wales, Australia.; 2. Centenary Institute of Cancer Medicine and Cell Biology, Sydney, New South Wales, Australia.; 3. Central Clinical School, Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia.; 4. National Lung Hospital, Hanoi, Vietnam.; 5. Hanoi Lung Hospital, Hanoi, Vietnam.; 6. Department of Tuberculosis, Hanoi Medical University, Hanoi, Vietnam.; McGill University, Canada, |
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Abstract: | SettingExisting tuberculosis control strategies in Vietnam are based on symptomatic patients attending health services for investigation. This approach has not resulted in substantial reductions in the prevalence of tuberculosis disease, despite the National Tuberculosis Program achieving high treatment completion rates. Alternative approaches are being considered.ObjectiveTo determine the feasibility and yield of contact investigation in households of patients with smear positive pulmonary tuberculosis among household members of tuberculosis patients in Hanoi, Vietnam.MethodsHousehold contacts of patients with smear positive pulmonary tuberculosis were recruited at four urban and rural District Tuberculosis Units in Hanoi. Clinical and radiological screening was conducted at baseline, six months and 12 months. Sputum microscopy and culture was performed in contacts suspected of having tuberculosis. MIRU-VNTR molecular testing was used to compare the strains of patients and their contacts with disease.ResultsAmong 545 household contacts of 212 patients, four were diagnosed with tuberculosis at baseline (prevalence 734 cases per 100,000 persons, 95% CI 17–1451) and one was diagnosed with tuberculosis during the subsequent 12 months after initial screening (incidence 180 cases per 100,000 person-years, 95% CI 44–131). Two of these cases were culture positive for M. tuberculosis and both had identical or near-identical MIRU-VNTR strain types.ConclusionHousehold contacts of patients with potentially infectious forms of tuberculosis have a high prevalence of disease. Household contact investigation is feasible in Vietnam. Further research is required to investigate its effectiveness. |
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