Prevalence of latent tuberculosis infection in the household contacts of pulmonary tuberculosis, time to treat

Abstract

Treatment of latent pulmonary tuberculosis (TB) in the household contacts of TB has been included in the National Tuberculosis Elimination Program (NTEP) to achieve the target of TB elimination of Govt of India by 2025. However, there are no clear estimates of the prevalence of latent TB among the contacts that could suggest the impact of this intervention. The study was conducted to find the prevalence of and factors predicting latent TB among household contacts of pulmonary TB. All microbiological confirmed pulmonary TB patients registered between January 2020 to July 2021 and their household contacts were enrolled. All contacts underwent Mantoux testing to find the prevalence of latent TB. All symptomatic patients also underwent CXR and sputum examination to diagnose active pulmonary TB. Thereafter different demographic and clinical factors were evaluated to find predictors of latent TB using logistic regression model.  A total of 118 pulmonary TB cases and their 330 household contacts were enrolled. The prevalence of latent TB and active TB among the contacts was found to be 26.36% and 3.03% respectively. The female gender of index TB cases was independently associated with a high proportion of latent TB cases in the family. (aOR-2.32; 95%CI-1.07-5.05; p=0.03). Neither the higher sputum smear positivity nor the severity of chest radiograph of index TB cases had any association with the number of contacts being diagnosed as latent TB or active TB. The results showed a significant prevalence of latent TB among household contacts with pulmonary TB. The severity of the disease in the index patient had no association with the prevalence of latent TB.