Risk Factors for Tuberculosis (TB) Among Household Contacts of Patients With Smear-Positive TB in 8 Provinces of Vietnam: A Nested Case-Control Study

Risk Factors for Tuberculosis (TB) Among Household Contacts of Patients With Smear-Positive TB in 8 Provinces of Vietnam: A Nested Case-Control Study.

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Item Type: Article
Status: Published
Official URL: https://doi.org/10.1093/cid%2Fciaa1742
Journal or Publication Title: Clinical Infectious Diseases
Volume: 73
Number: 9
Page Range: e3358-e3364
Date: 2 November 2021
Divisions: Tuberculosis
Depositing User: General Admin
Identification Number: 10.1093/cid/ciaa1742
ISSN: 1058-4838
Date Deposited: 07 Dec 2021 09:50

Background: Tuberculosis (TB) continues to account for significant morbidity and mortality annually. Household contacts (HHCs) of persons with TB are a key population for targeting prevention and control interventions. We aimed to identify risk factors associated with developing TB among HHCs.

Methods: We conducted a nested case-control study among HHCs in 8 provinces in Vietnam enrolled in a randomized controlled trial of active case finding for TB. Cases were any HHCs diagnosed and registered with TB within the Vietnam National TB Program during 2 years of follow-up. Controls were selected by simple random sampling from the remaining HHCs. Risk factor data were collected at enrollment and during follow-up. A logistic regression model was developed to determine predictors of TB among HHCs.

Results: We selected 1254 HHCs for the analysis: 214 cases and 1040 controls. Underlying characteristics varied between both groups; cases were older, more likely to be male, with a higher proportion of reported previous TB and diabetes. Risk factors associated with a TB diagnosis included being male (adjusted odds ratio [aOR], 1.4; 95% confidence interval [CI], 1.03-2.0), residing in an urban setting (aOR, 1.8; 1.3-2.5), prior TB (aOR, 4.6; 2.5-8.7), history of diabetes (aOR, 3.1; 1.7-5.8), current smoking (aOR, 3.1; 2.2-4.4), and prolonged history of coughing in the index case at enrollment (OR , 1.6; 1.1-2.3).

Conclusions: Household contacts remain an important key population for TB prevention and control. TB programs should ensure effective contact investigations are implemented for household contacts, particularly those with additional risk factors for developing TB.

Keywords: active case finding; contact investigation; household; tuberculosis.

© The Author(s) 2020. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.

Velen, Kavindhran
Nhung, Nguyen Viet
Anh, Nguyen Thu
Cuong, Pham Duc
Hoa, Nguyen Binh
Cuong, Nguyen Kim
Dung, Nguyen Huy
Sy, Dinh Ngoc
Britton, Warwick John
Marks, Guy Barrington
Fox, Greg James
Last Modified: 07 Dec 2021 09:50
URI: https://eprints.centenary.org.au/id/eprint/1164

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