Assessment and evaluation of contact as a risk factor for tuberculosis in rural Africa

Crampin, A.C. , Floyd, S., Ngwira, B.M., Mwinuka, V., Mwaungulu, J.N., Branson, K., Fine, P.E.M. and Glynn, J.R. (2008) Assessment and evaluation of contact as a risk factor for tuberculosis in rural Africa. International Journal of Tuberculosis and Lung Disease, 12(6), pp. 612-618. (PMID:18492326) (PMCID:PMC2443279)

Abstract

Setting: A rural district in Malawi. Objective: To determine the effect of inaccurate recall on estimates of the proportion of tuberculosis (TB) cases attributable to contact with identifiable prior cases. Design: Case-control study of laboratory-confirmed TB cases and community controls, comparing family, household and area contacts identified from a database of TB cases with those named at interview. Estimation of prior contact as a risk factor for TB and identified factors associated with being a named contact. Results: Ninety-five per cent of named contacts were known TB cases. The proportion of total identified contacts who were named at interview was 75%, and was similar for cases and controls. Cases were twice as likely as controls to identify prior contacts. Adding database information did not affect odds ratios, but increased the proportion of TB cases attributable to prior contact. Smear-positive, male and human immunodeficiency virus (HIV) negative TB patients were more likely to be named by subsequent cases. Identifiable recent contact with known smear-positive cases accounted for 12.5% of the TB burden. Conclusions: Reporting of putative source contacts showed little evidence of recall bias and gave estimates of the relative risk of TB associated with identifiable contact. The lower likelihood of HIV-positive cases being named as contacts may reflect reduced infectiousness.

• Item Type: Articles
• Additional Information: The Karonga Prevention Study is funded by the Wellcome Trust and LEPRA and appreciates the support of the National Health Sciences Research Committee, the National Tuberculosis Control Programme of Malawi and the Karonga community.
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Crampin, Professor Mia
• Authors: Crampin, A.C., Floyd, S., Ngwira, B.M., Mwinuka, V., Mwaungulu, J.N., Branson, K., Fine, P.E.M., and Glynn, J.R.
• College/School: College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Public Health
• Journal Name: International Journal of Tuberculosis and Lung Disease
• Publisher: International Union Against Tuberculosis and Lung Disease
• ISSN: 1027-3719
• ISSN (Online): 1815-7920