Implementing contact tracing for tuberculosis in Kyrgyz Republic and risk factors for positivity using QuantiFERON-TB Gold plus

BMC Infectious Diseases

Dilorom Kosimova¹  Dasha Migunov¹  Evgeni Sahalchyk²  Uladzimir Antonenka²  Caroline Corbett²  Monica Vogel²  Nagira Umetalieva²  Harald Hoffmann³  Bakyt Myrzaliev⁴  Abdylat Kadyrov⁵  Gulmira Kalmambetova⁶  Altyn Iskakova⁶  Sevim Ahmedov⁷  Tatjana Toichkina⁸  Aizat Kulzhabaeva⁸ 

[1] ABT Associates, Washington DC, USA;Departments SYNLAB Gauting & IML red GmbH, WHO - Supranational Tuberculosis Reference Laboratory Munich-Gauting, Institute of Microbiology and Laboratory Medicine, Robert-Koch-Allee 2, D-82131, Gauting, Germany;Departments SYNLAB Gauting & IML red GmbH, WHO - Supranational Tuberculosis Reference Laboratory Munich-Gauting, Institute of Microbiology and Laboratory Medicine, Robert-Koch-Allee 2, D-82131, Gauting, Germany;SYNLAB Gauting, SYNLAB Human Genetics, Munich, Germany;KNCV Branch Office in the Kyrgyz Republic, Bishkek, Kyrgyz Republic;Republican Tuberculosis Center, National TB Program, Bishkek, Kyrgyz Republic;Republican Tuberculosis Reference Laboratory, Bishkek, Kyrgyz Republic;USAID, Washington DC, USA;fhi360; Defeat-TB program, Bishkek, Kyrgyz Republic;

关键词: Community contacts;    Tuberculosis;    Latent tuberculosis infection;    QuantiFERON;    Active case finding;    Contact tracing;   

DOI  :  10.1186/s12879-020-05465-x

来源: Springer

【 摘 要 】

BackgroundEffective active case finding (ACF) activities are essential for early identification of new cases of active tuberculosis (TB) and latent TB infection (LTBI). Accurate diagnostics as well as the ability to identify contacts at high risk of infection are essential for ACF, and have not been systematically reported from Central Asia. The objective was to implement a pilot ACF program to determine the prevalence and risk factors for LTBI and active TB among contacts of individuals with TB in Kyrgyz Republic using Quantiferon-TB Gold plus (QuantiFERON).MethodsAn enhanced ACF project in the Kyrgyz Republic was implemented in which close and household (home) contacts of TB patients from the Issyk-Kul Oblast TB Center were visited at home. QuantiFERON and the tuberculin skin test (TST) alongside clinical and bacteriological examination were used to identify LTBI and active TB cases among contacts. The association for QuantiFERON positivity and risk factors were analysed and compared to TST results.ResultsImplementation of ACF with QuantiFERON involved close collaboration with the national sanitary and epidemiological services (SES) and laboratories in the Kyrgyz Republic. From 67 index cases, 296 contacts were enrolled of whom 253 had QuantiFERON or TST results; of those 103 contacts had LTBI (positive TST or IGRA), and four (1.4%) active TB cases were detected. Index case smear microscopy (OR 1.76) and high household density (OR 1.97) were significant risk factors for QuantiFERON positivity for all contacts. When stratified by age, association with smear positivity disappeared for children below 15 years. TST was not associated with any risk factor.ConclusionsThis is the first time that ACF activities have been reported for Central Asia, and provide insight for implementation of effective ACF in the region. These ACF activities using QuantiFERON led to increase in the detection of LTBI and active cases, prior to patients seeking treatment. Household density should be taken into consideration as an important risk factor for the stratification of future ACF activities.

【 授权许可】

CC BY