Summary
Children are at risk of TB, especially if they are household contacts of someone newly diagnosed. Research is needed on outcome of paediatric household contacts of drug-resistant TB (DR-TB) index patients, where routine follow-up is usually offered instead of preventive treatment. We describe the yield of a contact investigation protocol implemented among children ages 0-14 years living with DR-TB patients.
A single centre prospective cohort study was conducted to follow-up paediatric household contacts of newly diagnosed (within last 6 months) sputum-positive pulmonary DR-TB patients in New Delhi, India. The study conducted symptom screening, tuberculin skin testing, chest X-rays, and bacteriological testing at baseline and during the 1-year follow-up.
We found a high yield of TB disease at baseline and within the first four follow-up months, with 22/276 participants (8.0%) started on TB treatment. Of these 22, 7 were bacteriologically confirmed and 15 were clinically diagnosed. Of the 7 participants with bacteriologically confirmed TB, 5 were asymptomatic, suggesting symptom screening alone may not be effective.
We advocate for early screening and diagnosis coupled with TB preventive treatment, instead of rigorous follow-ups as means of preventing paediatric DR-TB in household contacts.
