Identification of subclinical tuberculosis in household contacts using exposure scores and contact investigations

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Identification of subclinical tuberculosis in household contacts using exposure scores and contact investigations. / Bekken, Gry Klouman; Ritz, Christian; Selvam, Sumithra; Jesuraj, Nelson; Hesseling, Anneke C; Doherty, T Mark; Grewal, Harleen M S; Vaz, Mario; Jenum, Synne.

I: BMC Infectious Diseases, Bind 20, 96, 2020.

Publikation: Bidrag til tidsskriftTidsskriftartikelfagfællebedømt

Harvard

Bekken, GK, Ritz, C, Selvam, S, Jesuraj, N, Hesseling, AC, Doherty, TM, Grewal, HMS, Vaz, M & Jenum, S 2020, 'Identification of subclinical tuberculosis in household contacts using exposure scores and contact investigations', BMC Infectious Diseases, bind 20, 96. https://doi.org/10.1186/s12879-020-4800-y

APA

Bekken, G. K., Ritz, C., Selvam, S., Jesuraj, N., Hesseling, A. C., Doherty, T. M., Grewal, H. M. S., Vaz, M., & Jenum, S. (2020). Identification of subclinical tuberculosis in household contacts using exposure scores and contact investigations. BMC Infectious Diseases, 20, [96]. https://doi.org/10.1186/s12879-020-4800-y

Vancouver

Bekken GK, Ritz C, Selvam S, Jesuraj N, Hesseling AC, Doherty TM o.a. Identification of subclinical tuberculosis in household contacts using exposure scores and contact investigations. BMC Infectious Diseases. 2020;20. 96. https://doi.org/10.1186/s12879-020-4800-y

Author

Bekken, Gry Klouman ; Ritz, Christian ; Selvam, Sumithra ; Jesuraj, Nelson ; Hesseling, Anneke C ; Doherty, T Mark ; Grewal, Harleen M S ; Vaz, Mario ; Jenum, Synne. / Identification of subclinical tuberculosis in household contacts using exposure scores and contact investigations. I: BMC Infectious Diseases. 2020 ; Bind 20.

Bibtex

@article{56bb4ef7ba7549cab9e14970a42914ed,
title = "Identification of subclinical tuberculosis in household contacts using exposure scores and contact investigations",
abstract = "Background: The goal of tuberculosis elimination put forward in the End TB Strategy prioritizes diagnosis and treatment of incipient and subclinical TB, recently defined by key stakeholders as {"}asymptomatic, early pre-clinical disease during which pathology evolves{"}. Regarded as indicative of a high risk of TB progression, considerable efforts have been made to identify these cases through exploration of biomarkers. The present study aimed to evaluate simple scoring systems for TB exposure as screening tools for subclinical TB, the only identifiable of the incipient and subclinical disease states, in a contact investigation (CI) setting of low HIV-prevalence.Methods: Nested within a large prospective study in household contacts (HHCs) of smear positive pulmonary TB cases in South-India conducted 2010-2012, we assessed 1) the association between the Tuberculosis Contact Score (TCS) and the Infectivity Score, with established tools for Mycobacterium tuberculosis (Mtb) infection, corrected for established TB risk factors, and 2) the capability of the TB exposure scores to identify subclinical TB defined by Mtb-culture positivity in sputum or gastric aspirate (subjects < 5 years) specimen.Results: Of 525 HHCs, 29 were Mtb-culture positive and 96.6% of these asymptomatic. The TCS and the Infectivity Score associated with positive Tuberculin Skin Test and QuantiFeron TB-Gold In-tube assay (QFT) results in multivariate analyses (TCS: ORTST 1.16, 95% CI: 1.01, 1.33; ORQFT 1.33 95% CI: 1.16, 1.51. Infectivity Score: ORTST 1.39, 95% CI: 1.10, 1.76; ORQFT 1.41 95% CI: 1.16, 1.71). The Infectivity Score showed a moderate capability to identify subclinical TB (AUC of 0.61, 95% CI: 0.52, 0.70).Conclusions: Although our results did not identify an easily applicable screening tool for subclinical TB, the present study indicates that focusing on TB-related symptoms in CI settings may be of limited value for early identification of HHCs with high risk for TB progression.",
keywords = "Faculty of Science, Pulmonary tuberculosis, Cohort studies, Transmission, Risk assessment, Point scoring systems, Prevention",
author = "Bekken, {Gry Klouman} and Christian Ritz and Sumithra Selvam and Nelson Jesuraj and Hesseling, {Anneke C} and Doherty, {T Mark} and Grewal, {Harleen M S} and Mario Vaz and Synne Jenum",
note = "CURIS 2020 NEXS 030",
year = "2020",
doi = "10.1186/s12879-020-4800-y",
language = "English",
volume = "20",
journal = "B M C Infectious Diseases",
issn = "1471-2334",
publisher = "BioMed Central Ltd.",

}

RIS

TY - JOUR

T1 - Identification of subclinical tuberculosis in household contacts using exposure scores and contact investigations

AU - Bekken, Gry Klouman

AU - Ritz, Christian

AU - Selvam, Sumithra

AU - Jesuraj, Nelson

AU - Hesseling, Anneke C

AU - Doherty, T Mark

AU - Grewal, Harleen M S

AU - Vaz, Mario

AU - Jenum, Synne

N1 - CURIS 2020 NEXS 030

PY - 2020

Y1 - 2020

N2 - Background: The goal of tuberculosis elimination put forward in the End TB Strategy prioritizes diagnosis and treatment of incipient and subclinical TB, recently defined by key stakeholders as "asymptomatic, early pre-clinical disease during which pathology evolves". Regarded as indicative of a high risk of TB progression, considerable efforts have been made to identify these cases through exploration of biomarkers. The present study aimed to evaluate simple scoring systems for TB exposure as screening tools for subclinical TB, the only identifiable of the incipient and subclinical disease states, in a contact investigation (CI) setting of low HIV-prevalence.Methods: Nested within a large prospective study in household contacts (HHCs) of smear positive pulmonary TB cases in South-India conducted 2010-2012, we assessed 1) the association between the Tuberculosis Contact Score (TCS) and the Infectivity Score, with established tools for Mycobacterium tuberculosis (Mtb) infection, corrected for established TB risk factors, and 2) the capability of the TB exposure scores to identify subclinical TB defined by Mtb-culture positivity in sputum or gastric aspirate (subjects < 5 years) specimen.Results: Of 525 HHCs, 29 were Mtb-culture positive and 96.6% of these asymptomatic. The TCS and the Infectivity Score associated with positive Tuberculin Skin Test and QuantiFeron TB-Gold In-tube assay (QFT) results in multivariate analyses (TCS: ORTST 1.16, 95% CI: 1.01, 1.33; ORQFT 1.33 95% CI: 1.16, 1.51. Infectivity Score: ORTST 1.39, 95% CI: 1.10, 1.76; ORQFT 1.41 95% CI: 1.16, 1.71). The Infectivity Score showed a moderate capability to identify subclinical TB (AUC of 0.61, 95% CI: 0.52, 0.70).Conclusions: Although our results did not identify an easily applicable screening tool for subclinical TB, the present study indicates that focusing on TB-related symptoms in CI settings may be of limited value for early identification of HHCs with high risk for TB progression.

AB - Background: The goal of tuberculosis elimination put forward in the End TB Strategy prioritizes diagnosis and treatment of incipient and subclinical TB, recently defined by key stakeholders as "asymptomatic, early pre-clinical disease during which pathology evolves". Regarded as indicative of a high risk of TB progression, considerable efforts have been made to identify these cases through exploration of biomarkers. The present study aimed to evaluate simple scoring systems for TB exposure as screening tools for subclinical TB, the only identifiable of the incipient and subclinical disease states, in a contact investigation (CI) setting of low HIV-prevalence.Methods: Nested within a large prospective study in household contacts (HHCs) of smear positive pulmonary TB cases in South-India conducted 2010-2012, we assessed 1) the association between the Tuberculosis Contact Score (TCS) and the Infectivity Score, with established tools for Mycobacterium tuberculosis (Mtb) infection, corrected for established TB risk factors, and 2) the capability of the TB exposure scores to identify subclinical TB defined by Mtb-culture positivity in sputum or gastric aspirate (subjects < 5 years) specimen.Results: Of 525 HHCs, 29 were Mtb-culture positive and 96.6% of these asymptomatic. The TCS and the Infectivity Score associated with positive Tuberculin Skin Test and QuantiFeron TB-Gold In-tube assay (QFT) results in multivariate analyses (TCS: ORTST 1.16, 95% CI: 1.01, 1.33; ORQFT 1.33 95% CI: 1.16, 1.51. Infectivity Score: ORTST 1.39, 95% CI: 1.10, 1.76; ORQFT 1.41 95% CI: 1.16, 1.71). The Infectivity Score showed a moderate capability to identify subclinical TB (AUC of 0.61, 95% CI: 0.52, 0.70).Conclusions: Although our results did not identify an easily applicable screening tool for subclinical TB, the present study indicates that focusing on TB-related symptoms in CI settings may be of limited value for early identification of HHCs with high risk for TB progression.

KW - Faculty of Science

KW - Pulmonary tuberculosis

KW - Cohort studies

KW - Transmission

KW - Risk assessment

KW - Point scoring systems

KW - Prevention

U2 - 10.1186/s12879-020-4800-y

DO - 10.1186/s12879-020-4800-y

M3 - Journal article

C2 - 32005136

VL - 20

JO - B M C Infectious Diseases

JF - B M C Infectious Diseases

SN - 1471-2334

M1 - 96

ER -

ID: 237367617