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RESEARCH ARTICLE

What do we know about the outcomes of tuberculosis contact investigations in NSW?

Claudia C. Dobler
+ Author Affiliations
- Author Affiliations

Department of Respiratory and Environmental Epidemiology, Woolcock Institute of Medical Research, The University of Sydney
Email: cdobler@med.usyd.edu.au

NSW Public Health Bulletin 24(1) 34-37 https://doi.org/10.1071/NB12099
Published: 15 July 2013

Abstract

A recently conducted study on tuberculosis contact investigations in six Sydney tuberculosis clinics – that together managed 59% of all tuberculosis cases in NSW from January 2000 to December 2009 – found that the prevalence of tuberculosis among contacts was comparable to other low-incidence settings. However, only 9% of contacts with latent tuberculosis infection received treatment. This paper explores the results of the study, evaluating potential missed opportunities to prevent tuberculosis among contacts, and discussing the mechanisms in decision making about treatment of latent tuberculosis infection. In particular, the paper focuses on the challenges of tuberculin skin test interpretation among contacts who have received Bacille Calmette-Guérin vaccination and who were born in countries where tuberculosis is endemic.


References

[1]  American Thoracic Society. Targeted tuberculin testing and treatment of latent tuberculosis infection. Am J Respir Crit Care Med 2000; 161 S221–47.
| 10764341PubMed |

[2]  NSW Health. Tuberculosis Contact Tracing. Policy Directive PD2008_017. Available at: http://www.health.nsw.gov.au/policies/pd/2008/pdf/PD2008_017.pdf (Cited 30 December 2012).

[3]  NSW Health. Preventive Therapy. Policy Directive PD2005_072. Available at: http://www.health.nsw.gov.au/policies/PD/2005/pdf/PD2005_072.pdf (Cited 30 December 2012).

[4]  NSW Health. Tuberculin Skin Testing. Policy Directive PD2009_005. Available at: http://www.health.nsw.gov.au/policies/pd/2009/pdf/PD2009_005.pdf (Cited 30 December 2012).

[5]  Dobler CC, Marks GB. Risk of tuberculosis among contacts in a low incidence setting. Eur Respir J (in press)

[6]  Fox GJ, Barry SE, Britton WJ, Marks GB. Contact investigation for tuberculosis: a systematic review and meta-analysis. Eur Respir J 2013; 41 140–56.
Contact investigation for tuberculosis: a systematic review and meta-analysis.Crossref | GoogleScholarGoogle Scholar | 22936710PubMed |

[7]  American Thoracic Society/Centers for Disease Control and Prevention/Infectious Diseases Society of America Controlling tuberculosis in the United States. Am J Respir Crit Care Med 2005; 172 1169–227.
Controlling tuberculosis in the United States.Crossref | GoogleScholarGoogle Scholar | 16249321PubMed |

[8]  Erkens CG, Kamphorst M, Abubakar I, Bothamley GH, Chemtob D, Haas W, et al. Tuberculosis contact investigation in low prevalence countries: a European consensus. Eur Respir J 2010; 36 925–49.
Tuberculosis contact investigation in low prevalence countries: a European consensus.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BC3cfmvFCqug%3D%3D&md5=162575d130dbe539264af86481fbc490CAS | 20889463PubMed |

[9]  American Thoracic Society, American Lung Association, Center for Disease Control Preventive therapy of tuberculosis infection. Am Rev Respir Dis 1974; 110 371–4.
| 4415195PubMed |

[10]  Kopanoff DE, Snider DE, Caras GJ. Isoniazid-related hepatitis: a U.S. Public Health Service cooperative surveillance study. Am Rev Respir Dis 1978; 117 991–1001.
| 1:STN:280:DyaE1c3gvFSrsw%3D%3D&md5=e7f91df9efa6957e2f30a21a7f3e9f59CAS | 666111PubMed |

[11]  Rangaka MX, Wilkinson KA, Glynn JR, Ling D, Menzies D, Mwansa-Kambafwile J, et al. Predictive value of interferon-gamma release assays for incident active tuberculosis: a systematic review and meta-analysis. Lancet Infect Dis 2012; 12 45–55.
Predictive value of interferon-gamma release assays for incident active tuberculosis: a systematic review and meta-analysis.Crossref | GoogleScholarGoogle Scholar | 1:CAS:528:DC%2BC38XhtVClsw%3D%3D&md5=d89763baa404d719f0bc335edb70f238CAS | 21846592PubMed |

[12]  Diel R, Loddenkemper R, Nienhaus A. Predictive value of interferon-gamma release assays and tuberculin skin testing for predicting progression from latent TB infection to disease state: a meta-analysis. Chest 2012; 142 63–75.
Predictive value of interferon-gamma release assays and tuberculin skin testing for predicting progression from latent TB infection to disease state: a meta-analysis.Crossref | GoogleScholarGoogle Scholar | 1:CAS:528:DC%2BC38Xht1GmtrjN&md5=d8dd904b648e50768e17a8a5be1af65fCAS | 22490872PubMed |

[13]  National Institute for Health and Clinical Excellence. NICE clinical guideline 117. Tuberculosis: clinical diagnosis and management of tuberculosis, and measures for its prevention and control. London; 2011.

[14]  Mazurek GH, Jereb J, Vernon A, LoBue P, Goldberg S, Castro K. Updated guidelines for using Interferon Gamma Release Assays to detect Mycobacterium tuberculosis infection – United States, 2010. MMWR Recomm Rep 2010; 59 1–25.
| 20577159PubMed |

[15]  National Tuberculosis Advisory Committee Position statement on interferon-gamma release assays in the detection of latent tuberculosis infection. Commun Dis Intell 2012; 36 125–31.

[16]  Ferebee SH. Controlled chemoprophylaxis trials in tuberculosis. A general review. Bibl Tuberc 1970; 26 28–106.
| 1:STN:280:DyaE3c%2FotVSktQ%3D%3D&md5=7e2bcaafada7a3ae0670d21621502318CAS | 4903501PubMed |

[17]  Tan MC, Marra CA, Sadatsafavi M, Marra F, Morán-Mendoza O, Moadebi S, et al. Cost-effectiveness of LTBI treatment for TB contacts in British Columbia. Value Health 2008; 11 842–52.
Cost-effectiveness of LTBI treatment for TB contacts in British Columbia.Crossref | GoogleScholarGoogle Scholar | 18489519PubMed |

[18]  Dasgupta K, Schwartzman K, Marchand R, Tennenbaum TN, Brassard P, Menzies D. Comparison of cost-effectiveness of tuberculosis screening of close contacts and foreign-born populations. Am J Respir Crit Care Med 2000; 162 2079–86.
| 1:STN:280:DC%2BD3M7gt1yltA%3D%3D&md5=5d070d2cf560a37d0434737155205103CAS | 11112118PubMed |

[19]  Dobler CC, Marks GB. Completion of treatment for latent tuberculosis infection with monthly drug dispensation directly through the tuberculosis clinic. PLoS ONE 2012; 7 e48900
Completion of treatment for latent tuberculosis infection with monthly drug dispensation directly through the tuberculosis clinic.Crossref | GoogleScholarGoogle Scholar | 1:CAS:528:DC%2BC38XhslajurrE&md5=b830a0ff0a142c6cc4b4722b4bc5685cCAS | 23139824PubMed |

[20]  Smieja MJ, Marchetti CA, Cook DJ, Smaill FM. Isoniazid for preventing tuberculosis in non-HIV infected persons. Cochrane Database Syst Rev 2000; CD001363
| 1:STN:280:DC%2BD3c3lslOgsA%3D%3D&md5=bd353c8be5aae735de3f621f19c5240aCAS | 10796642PubMed |

[21]  Comstock GW. How much isoniazid is needed for prevention of tuberculosis among immunocompetent adults? Int J Tuberc Lung Dis 1999; 3 847–50.
| 1:STN:280:DyaK1Mvlt1aisg%3D%3D&md5=907b276528ef8bf1ba46a44b0b161a34CAS | 10524579PubMed |