American Journal of Epidemiology and Infectious Disease
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American Journal of Epidemiology and Infectious Disease. 2016, 4(2), 34-41
DOI: 10.12691/ajeid-4-2-3
Open AccessReview Article

Prevalence and Risk of Active Tuberculosis among Symptomatic Household Contacts of Bacteriologically Confirmed Pulmonary Tuberculosis Subjects Treated at the Buea Regional Hospital of the Southwest Region of Cameroon

Irene Ane Anyangwe1, , Henry Dilonga Meriki1, 2, Damian Nota Anong1, Chi Joseph Shu1, Kukwah Anthony Tufon1, 3, Fritz Roland Nsonghomanyi Fonkeng1, Nkwain Victorine Nayah4, Kah Emmanuel Nji4, Theresa Nkuo-Akenji1, Fidelis Chongwa5 and Vincent PK Titanji6

1Department of Microbiology and Parasitology, Faculty of science, P.O. 63, Buea University of Buea, Cameroon

2TB Diagnostic Unit, Regional hospital Buea, Cameroon;Department of Public Health and Hygiene, Faculty of Health science, University of Buea, Cameroon

3TB Diagnostic Unit, Regional hospital Buea, Cameroon

4Department of Public Health and Hygiene, Faculty of Health science, University of Buea, Cameroon

5Department of Biochemistry and Molecular Biology, University of Buea

6Biotechnology Unit, Faculty of Science, University of Buea

Pub. Date: June 07, 2016

Cite this paper:
Irene Ane Anyangwe, Henry Dilonga Meriki, Damian Nota Anong, Chi Joseph Shu, Kukwah Anthony Tufon, Fritz Roland Nsonghomanyi Fonkeng, Nkwain Victorine Nayah, Kah Emmanuel Nji, Theresa Nkuo-Akenji, Fidelis Chongwa and Vincent PK Titanji. Prevalence and Risk of Active Tuberculosis among Symptomatic Household Contacts of Bacteriologically Confirmed Pulmonary Tuberculosis Subjects Treated at the Buea Regional Hospital of the Southwest Region of Cameroon. American Journal of Epidemiology and Infectious Disease. 2016; 4(2):34-41. doi: 10.12691/ajeid-4-2-3

Abstract

Background: Tuberculosis (TB) remains a serious public health concern worldwide. The predominant global strategy for identifying people with TB is ‘passive case detection’ which has a low case detection rate therefore is an obstacle to the long-term success of TB control programs, giving the possibility of undiagnosed patients posing great risk of transmitting the infection to others. Methods: A hospital/community-based cross-sectional study was conducted on 921 clinically suspected consented TB patients and those confirmed by microscopy of Ziehl Neelsen stain for Acid fast bacilli (AFB) were contacted at their residence so as to identify any household contacts (HHC) with symptoms of TB. AFB Smear negative cases were further investigated using sodium hypochlorite (NaOCl) centrifuge-concentrated smears technique. Data was collected from participants and the results were summarized using descriptive statistics, bivariate and multivariate logistic regression analyses. Results: The prevalence of pulmonary TB was 20.6% (190/921) and 7.04% (5/71) among TB suspected cases and symptomatic HHC respectively. In a univariate analysis, age group (p = 0.011), marital status (p = 0.019), employment status (p = 0.041), previous TB contact (p < 0.001), HIV status (p = 0.001) and family size (p = 0.003) were associated with TB occurrence. However, only HIV status (AOR = 4.98, 95% CI = 1.73 - 14.34) and previous TB contact (AOR = 6.08 95% CI = 2.86-12.89) were independently associated with TB occurrence. Approximately 30% of the diagnosed TB cases were detected with sodium hypochlorite (NaOCl) centrifuge-concentrated smears. Conclusion: The study showed that, contact investigation can improve case detection rates for active tuberculosis and therefore can augment the existing comprehensive package of interventions that could substantially reduce at the population level TB disease burden. Risk factors such as family size > 5 persons, previous contact with TB patients, marital and HIV status were associated with TB prevalence. Concentration technique is more effective with a higher rate of detection compared to direct smear.

Keywords:
household contacts bacteriologically confirmed tuberculosis risks factors sodium hypochlorite centrifuged-concentrated smear

Creative CommonsThis work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/

References:

[1]  Fox GJ, Nhung NV, Sy DN, Britton WJ, Marks GB: Household contact investigation for tuberculosis in Vietnam: study protocol for a cluster randomized controlled trial. Trials 2013, 14:1-15.
 
[2]  Kranzer K, Afnan-Holmes H, Tomlin K, Golub JE, Shapiro AE, Schaap A, Corbett EL, L??nnroth K, Glynn JR: The benefits to communities and individuals of screening for active tuberculosis disease: A systematic review. Int J Tuberc Lung Dis 2013, 17: 432-446.
 
[3]  Kuaban C, Koulla-Shiro S, Lekama Assiene T, Hagbe P: [Tuberculosis screening of patient contacts in 1993 and 1994 in Yaounde, Cameroon]. Médecine Trop Rev du Corps santé Colon 1996, 56:156-8.
 
[4]  World Health Organization: Global Tuberculosis Report 2014. 2014.
 
[5]  Triasih R, Rutherford M, Lestari T, Utarini A, Robertson CF, Graham SM: Contact investigation of children exposed to tuberculosis in South East Asia: A systematic review. Journal of Tropical Medicine 2012.
 
[6]  Marais BJ, Gie RP, Schaaf HS, Hesseling a C, Obihara CC, Nelson LJ, Enarson D a, Donald PR, Beyers N: The clinical epidemiology of childhood pulmonary tuberculosis: a critical review of literature from the pre-chemotherapy era. Int J Tuberc Lung Dis 2004, 8:278-85.
 
[7]  Singh J, Sankar MM, Kumar S, Gopinath K, Singh N, Mani K, Singh S: Incidence and Prevalence of Tuberculosis among Household Contacts of Pulmonary Tuberculosis Patients in a Peri-Urban Population of South Delhi, India. PLoS One 2013, 8.
 
[8]  Who: Global tuberculosis control: WHO report 2011. Who 2011:258.
 
[9]  Odusanya OO, Babafemi JO: Patterns of delays amongst pulmonary tuberculosis patients in Lagos, Nigeria. BMC Public Health 2004, 4:18.
 
[10]  Helping patients who drink too much: A clinicians guide [http://www.niaaa.nih.gov/publications].
 
[11]  Boccia D, Hargreaves J, De Stavola BL, Fielding K, Schaap A, Godfrey-Faussett P, Ayles H: The association between household socioeconomic position and prevalent tuberculosis in Zambia: a case-control study. PLoS One 2011, 6:e20824.
 
[12]  Harries AD, Nyirenda TE, Banerjee A, Boeree MJ, Salaniponi FML: The diagnosis of smear-negative pulmonary tuberculosis: The practice of sputum smear examination in Malawi. Int J Tuberc Lung Dis 1999, 3:896-900.
 
[13]  Swai HF, Mugusi FM, Mbwambo JK: Sputum smear negative pulmonary tuberculosis: sensitivity and specificity of diagnostic algorithm. BMC Res Notes 2011, 4:475.
 
[14]  Gebre-Selassie S: Evaluation of the concentration sputum smear technique for the laboratory diagnosis of pulmonary tuberculosis. Trop Doct 2003, 33:160-2.
 
[15]  Jackson-Sillah D, Hill PC, Fox A, Brookes RH, Donkor SA, Lugos MD, Howie SRC, Fielding KR, Jallow A, Lienhardt C, Corrah T, Adegbola RA, McAdam KP: Screening for tuberculosis among 2381 household contacts of sputum-smear-positive cases in The Gambia. Trans R Soc Trop Med Hyg 2007, 101:594-601.
 
[16]  Tulu B, Dida N, Kassa Y, Taye B: Smear positive pulmonary tuberculosis and its risk factors among tuberculosis suspect in South East Ethiopia; a hospital based cross-sectional study. BMC Res Notes 2014, 7:285.
 
[17]  Meriki HD, Tufon KA, Atanga PN, Ane-Anyangwe IN, Anong DN, Cho-Ngwa F, Nkuo-Akenji T: Drug Resistance Profiles of Mycobacterium tuberculosis Complex and Factors Associated with Drug Resistance in the Northwest and Southwest Regions of Cameroon. PLoS One 2013, 8:e77410.
 
[18]  EDS: Enquête Démographique et de Santé et À Indicateurs Multiples. 2011.
 
[19]  Magadi MA: Understanding the gender disparity in HIV infection across countries in sub-Saharan Africa: evidence from the Demographic and Health Surveys. Sociol Health Illn 2011, 33:522-39.
 
[20]  Fätkenheuer G, Taelman H, Lepage P, Schwenk A, Wenzel R: The return of tuberculosis. In Diagnostic Microbiology and Infectious Disease. Volume 34; 1999:139-146.
 
[21]  Saathoff E, Villamor E, Mugusi F, Bosch RJ, Urassa W, Fawzi WW: Anemia in adults with tuberculosis is associated with HIV and anthropometric status in Dar es Salaam, Tanzania. Int J Tuberc Lung Dis 2011, 15:925-932.
 
[22]  Jia Z, Cheng S, Ma Y, Zhang T, Bai L, Xu W, He X, Zhang P, Zhao J, Christiani DC: Tuberculosis burden in China: a high prevalence of pulmonary tuberculosis in household contacts with and without symptoms. BMC Infect Dis 2014, 14:64.
 
[23]  Becerra MC, Pachao-Torreblanca IF, Bayona J, Celi R, Shin SS, Kim JY, Farmer PE, Murray M: Expanding tuberculosis case detection by screening household contacts. Public Health Rep 2005, 120(June):271-277.
 
[24]  Glynn JR, Warndorff DK, Malema SS, Mwinuka V, Pönnighaus JM, Crampin a C, Fine PE: Tuberculosis: associations with HIV and socioeconomic status in rural Malawi. Trans R Soc Trop Med Hyg 1996, 94:500-3.
 
[25]  Hill PC, Jackson-Sillah D, Donkor SA, Otu J, Adegbola RA, Lienhardt C: Risk factors for pulmonary tuberculosis: a clinic-based case control study in The Gambia. BMC Public Health 2006, 6:156.
 
[26]  Richard Coker, Martin McKee, Rifat Atun, Boika Dimitrova, Ekaterina Dodonova, Sergei Kuznetsov FD: Risk factors for pulmonary tuberculosis in Russia: case-control study. BMJ (Clinical research ed.) 2006(January):85-87.
 
[27]  Tuberculosis Newsletter.
 
[28]  World Health Organization: Global Tuberculosis Report 2012. 2012.
 
[29]  Hussain H, Akhtar S, Nanan D: Prevalence of and risk factors associated with Mycobacterium tuberculosis infection in prisoners, North West Frontier Province, Pakistan. Int J Epidemiol 2003, 32:794-799.
 
[30]  Narasimhan P, Wood J, Macintyre CR, Mathai D: Risk factors for tuberculosis. Pulm Med 2013, 2013:828939.
 
[31]  Joshi R, Reingold AL, Menzies D, Pai M: Tuberculosis among health-care workers in low- and middle-income countries: A systematic review. PLoS Medicine 2006:2376-2391.
 
[32]  Golub JE, Cronin WA, Obasanjo OO, Coggin W, Moore K, Pope DS, Thompson D, Sterling TR, Harrington S, Bishai WR, Chaisson RE: Transmission of Mycobacterium tuberculosis through casual contact with an infectious case. Arch Intern Med 2001, 161:2254-8.
 
[33]  Taha M, Deribew A, Tessema F, Assegid S, Duchateau L, Colebunders R: Risk Factors of Active Tuberculosis in People Living with HIV/AIDS in Southwest Ethiopia: A Case Control Study. Ethiop J Health Sci 2011, 21:131-9.
 
[34]  Getahun H, Gunneberg C, Granich R, Nunn P: HIV infection-associated tuberculosis: the epidemiology and the response. Clin Infect Dis 2010, 50 Suppl 3:S201-S207.
 
[35]  Ejeta E, Ibrahim A, Tefera A, Mohammed A, Said A: Prevalence of Smear Positive Pulmonary Tuberculosis and its Associated Risk Factors among Patients Attending Nekemte Referral Hospital, Western Ethiopia. Sci Technol Arts Res J 2013, 2:85.