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| Dr Adams Tongman |
Feasibility, acceptability and yield of Tuberculosis household contact tracing within Rustenburg sub-district municipality.
Tongman A1, Maboyi S1, Morake B1, Mooketsi H1, Innes C1, Hoffmann C1, 2,Gresak G1,Charalambous S1
1 The Aurum Institute, South Africa
2 John Hopkins University, United States
Background: Active case finding among household contacts of smear positive TB cases might allow earlier diagnosis and treatment with reduce TB transmission, morbidity and mortality of patients. We evaluated the acceptability, feasibility and additional case detection of TB contact tracing within Rustenburg sub district municipality, an area with migrant population in a mixed peri-urban and rural settings.
Method: Patients diagnosed with infectious TB were identified from government health facilities, and after informed consent a nurse visited the household. All household contacts had a symptom screen for TB with sputum smear and culture done only on suspected TB cases. Onsite HIV testing was offered to all those = 16 years and those = 16 years who were a TB suspect. Clients needing further intervention were referred to public health facility
Results: Between April and December 2009, we recruited 563 index patient, 473(84%) had subsequent household visit. 2214 (100%) of the household contacts were symptomatically screened for TB and sputum was obtained from 540 (24.4%) contacts. 711 (61%) of those eligible for HIV testing consented, 167 (23%) had a positive result. 70 (3.2%) contacts were diagnosed with TB disease: 30 (42.9%) by culture, 12 (17.1%) by smear and 28(40%) via clinical suspicion. 55% (20) of the TB patients had a positive HIV test. 87 (25%) of contacts =5 years old were started on TB preventive therapy when referred to the clinics.
Conclusion: Tracing of household contacts of TB patients was feasible with high acceptance of household tracing and high uptake of TB screening and HIV testing. The prevalence of TB was 3.2 %, this is higher than the national average in the general population (0.96%).The high rate of diagnosis was achieved using sputum culture; smear microcopy alone would have missed the majority of TB cases among household contacts.
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