Tuberculosis: Which patients do not identify their contacts?

J. Josaphat, J. Gomes Dias, S. Salvador, V. Resende, R. Duarte
2014 Revista Portuguesa de Pneumologia  
Sociedade Portuguesa de Pneumologia Portugal Josaphat, J.; Gomes Dias, J.; Salvador, S.; Resende, V.; Duarte, R. Tuberculosis: Which patients do not identify their contacts? Revista Portuguesa de Pneumología, vol. 20, núm. 5, septiembre-octubre, 2014, pp. 242-247 Sociedade Portuguesa de Pneumologia Lisboa, Portugal Abstract Setting: It is not known what the magnitude of non-identified TB contacts is in our country, or the reasons why contacts at risk are not identified. Objective: The purpose
more » ... tive: The purpose of this study was to analyze the determinants associated with nonidentification of contacts. Design: This cross-sectional study included all cases of pulmonary tuberculosis diagnosed and treated in the Chest Disease Centre of Vila Nova de Gaia and their contacts, from 1st January to 31st December 2010. It included information collected from patients related to the identification of contacts in risk, and the information collected by the Public Health Unit during home, work and social places visits. Results: During the period of study, 61 cases of pulmonary TB were diagnosed: 41 cases (67.2%) identified all their contacts and 20 cases (32.8%) did not. 646 contacts were identified: 154 (23.8%) were identified only by the Public Health Unit (mean age of 40.67), and 492 (76.2%) were identified by the index cases (mean age of 33.25), (p = 0.001). A mean of 10.59 contacts were identified per index case, of which, 83 (19.3%) screened positive. From those identified by the Public Health Unit, 10 (9.8%) had LTBI and 5 (4.9%) had active TB, and by the index case 61 (18.6%) had LTBI and 7 (2.1%) had active TB (crude OR = 1.52; CI = 0.83---2.79). The multivariate analysis showed that employment (adjusted OR = 4.82; 95%CI = 1.71---13.54) was associated to non-identification of contacts and patients preferably tended to identify relatives and co-habitants (adjusted OR = 0.22; 95%CI = 0.10---0.47). Document downloaded from http://www.elsevier.pt, day 27/08/2014. This copy is for personal use. Any transmission of this document by any media or format is strictly prohibited. casos (67,2%) identificaram todos os seus contactos e 20 casos (32,8%) não o fizeram. Foram identificados 646 contactos: 154 (23,8%) foram identificados apenas pela Unidade de Saúde Pública (idade média de 40,67 anos) e 492 (76,2%) foram identificados pelos casos índice (idade média de 33,25, p = 0,001). Foram identificados uma média de 10,59 contactos por Caso Índice, dos quais 83 (19,3%) rastreados como positivos. Dos identificados pela Unidade de Saúde Pública, 10 (9,8%) tinham uma LTBI (infeção tuberculosa latente) e 5 (4,9%) TB ativa, e pelo Caso Índice, 61 (18,6%) tinham LTBI e 7 (2,1%) TB ativa, (OR bruto = 1,52; CI = 0,83---2,79). A análise multivariada mostrou que o emprego (OR ajustado = 4,82; 95% CI = 1,71---13,54) estava associado à não identificação de contactos e os doentes tinham tendência, preferencialmente, a identificar familiares e coabitantes (OR ajustado = 0,22; 95% CI = 0,10---0,47). Conclusão: Os doentes com TB tendem a identificar os contactos de familiares e coabitantes; os contactos no local de trabalho foram considerados um fator de risco independente para não ser identificado.
doi:10.1016/j.rppnen.2013.11.003 fatcat:jnpawfxgi5cglj6vhoefgbunoq