Incident Mycobacterium tuberculosis infection in household contacts of infectious tuberculosis patients in Brazil
Abstract Background In household contact investigations of tuberculosis (TB), a second tuberculin skin test (TST) obtained several weeks after a first negative result consistently identifies individuals that undergo TST conversion. It remains unclear whether this delay in M. tuberculosis infection i...
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| Format: | Article |
| Language: | English |
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BMC
2017-08-01
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| Series: | BMC Infectious Diseases |
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| Online Access: | http://link.springer.com/article/10.1186/s12879-017-2675-3 |
| _version_ | 1818260125301866496 |
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| author | Edward C. Jones-López Carlos Acuña-Villaorduña Geisa Fregona Patricia Marques-Rodrigues Laura F. White David Jamil Hadad Lucilia Pereira Dutra-Molina Solange Vinhas Avery I. McIntosh Mary Gaeddert Rodrigo Ribeiro-Rodrigues Padmini Salgame Moises Palaci David Alland Jerrold J. Ellner Reynaldo Dietze |
| author_facet | Edward C. Jones-López Carlos Acuña-Villaorduña Geisa Fregona Patricia Marques-Rodrigues Laura F. White David Jamil Hadad Lucilia Pereira Dutra-Molina Solange Vinhas Avery I. McIntosh Mary Gaeddert Rodrigo Ribeiro-Rodrigues Padmini Salgame Moises Palaci David Alland Jerrold J. Ellner Reynaldo Dietze |
| author_sort | Edward C. Jones-López |
| collection | DOAJ |
| description | Abstract Background In household contact investigations of tuberculosis (TB), a second tuberculin skin test (TST) obtained several weeks after a first negative result consistently identifies individuals that undergo TST conversion. It remains unclear whether this delay in M. tuberculosis infection is related to differences in the infectious exposure, TST boosting, partial host resistance, or some other factor. Methods We conducted a household contact study Vitória, Brazil. Between 2008 and 2013, we identified culture-positive pulmonary TB patients and evaluated their household contacts with both a TST and interferon gamma release assay (IGRA), and identified TST converters at 8–12 weeks post study enrollment. Contacts were classified as TST-positive (≥10 mm) at baseline, TST converters, or persistently TST-negative. We compared TST converters to TST-positive and to TST-negative contacts separately, using generalized estimating equations. Results We enrolled 160 index patients and 838 contacts; 523 (62.4%) were TST+, 62 (7.4%) TST converters, and 253 (30.2%) TST−. TST converters were frequently IGRA− at 8–12 weeks. In adjusted analyses, characteristics distinguishing TST converters from TST+ contacts (no contact with another TB patient and residence ownership) were different than those differentiating them from TST− contacts (stronger cough in index patient and contact BCG scar). Conclusions The individual risk and timing of M. tuberculosis infection within households is variable and dependent on index patient, contact and environmental factors within the household, and the surrounding community. Our findings suggest a threshold effect in the risk of infection in humans. |
| first_indexed | 2024-12-12T18:26:22Z |
| format | Article |
| id | doaj.art-78563ce390bd40cd92e115c3bbd120d1 |
| institution | Directory Open Access Journal |
| issn | 1471-2334 |
| language | English |
| last_indexed | 2024-12-12T18:26:22Z |
| publishDate | 2017-08-01 |
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| series | BMC Infectious Diseases |
| spelling | doaj.art-78563ce390bd40cd92e115c3bbd120d12022-12-22T00:16:01ZengBMCBMC Infectious Diseases1471-23342017-08-0117111010.1186/s12879-017-2675-3Incident Mycobacterium tuberculosis infection in household contacts of infectious tuberculosis patients in BrazilEdward C. Jones-López0Carlos Acuña-Villaorduña1Geisa Fregona2Patricia Marques-Rodrigues3Laura F. White4David Jamil Hadad5Lucilia Pereira Dutra-Molina6Solange Vinhas7Avery I. McIntosh8Mary Gaeddert9Rodrigo Ribeiro-Rodrigues10Padmini Salgame11Moises Palaci12David Alland13Jerrold J. Ellner14Reynaldo Dietze15Section of Infectious Diseases, Department of Medicine, Boston Medical Center and Boston University School of MedicineSection of Infectious Diseases, Department of Medicine, Boston Medical Center and Boston University School of MedicineNúcleo de Doenças Infecciosas, Universidade Federal do Espírito Santo (UFES)Núcleo de Doenças Infecciosas, Universidade Federal do Espírito Santo (UFES)Department of Biostatistics, Boston University School of Public HealthNúcleo de Doenças Infecciosas, Universidade Federal do Espírito Santo (UFES)Núcleo de Doenças Infecciosas, Universidade Federal do Espírito Santo (UFES)Mycobacteriology Laboratory, Núcleo de Doenças Infecciosas, UFESDepartment of Biostatistics, Boston University School of Public HealthSection of Infectious Diseases, Department of Medicine, Boston Medical Center and Boston University School of MedicineCellular and Molecular Immunology Laboratory, Núcleo de Doenças Infecciosas, UFESDivision of Infectious Diseases, Department of Medicine, New Jersey Medical School- Rutgers UniversityMycobacteriology Laboratory, Núcleo de Doenças Infecciosas, UFESDivision of Infectious Diseases, Department of Medicine, New Jersey Medical School- Rutgers UniversitySection of Infectious Diseases, Department of Medicine, Boston Medical Center and Boston University School of MedicineNúcleo de Doenças Infecciosas, Universidade Federal do Espírito Santo (UFES)Abstract Background In household contact investigations of tuberculosis (TB), a second tuberculin skin test (TST) obtained several weeks after a first negative result consistently identifies individuals that undergo TST conversion. It remains unclear whether this delay in M. tuberculosis infection is related to differences in the infectious exposure, TST boosting, partial host resistance, or some other factor. Methods We conducted a household contact study Vitória, Brazil. Between 2008 and 2013, we identified culture-positive pulmonary TB patients and evaluated their household contacts with both a TST and interferon gamma release assay (IGRA), and identified TST converters at 8–12 weeks post study enrollment. Contacts were classified as TST-positive (≥10 mm) at baseline, TST converters, or persistently TST-negative. We compared TST converters to TST-positive and to TST-negative contacts separately, using generalized estimating equations. Results We enrolled 160 index patients and 838 contacts; 523 (62.4%) were TST+, 62 (7.4%) TST converters, and 253 (30.2%) TST−. TST converters were frequently IGRA− at 8–12 weeks. In adjusted analyses, characteristics distinguishing TST converters from TST+ contacts (no contact with another TB patient and residence ownership) were different than those differentiating them from TST− contacts (stronger cough in index patient and contact BCG scar). Conclusions The individual risk and timing of M. tuberculosis infection within households is variable and dependent on index patient, contact and environmental factors within the household, and the surrounding community. Our findings suggest a threshold effect in the risk of infection in humans.http://link.springer.com/article/10.1186/s12879-017-2675-3Household contact studyM. tuberculosis infectionTST conversionBrazilLatent tuberculosis infection |
| spellingShingle | Edward C. Jones-López Carlos Acuña-Villaorduña Geisa Fregona Patricia Marques-Rodrigues Laura F. White David Jamil Hadad Lucilia Pereira Dutra-Molina Solange Vinhas Avery I. McIntosh Mary Gaeddert Rodrigo Ribeiro-Rodrigues Padmini Salgame Moises Palaci David Alland Jerrold J. Ellner Reynaldo Dietze Incident Mycobacterium tuberculosis infection in household contacts of infectious tuberculosis patients in Brazil BMC Infectious Diseases Household contact study M. tuberculosis infection TST conversion Brazil Latent tuberculosis infection |
| title | Incident Mycobacterium tuberculosis infection in household contacts of infectious tuberculosis patients in Brazil |
| title_full | Incident Mycobacterium tuberculosis infection in household contacts of infectious tuberculosis patients in Brazil |
| title_fullStr | Incident Mycobacterium tuberculosis infection in household contacts of infectious tuberculosis patients in Brazil |
| title_full_unstemmed | Incident Mycobacterium tuberculosis infection in household contacts of infectious tuberculosis patients in Brazil |
| title_short | Incident Mycobacterium tuberculosis infection in household contacts of infectious tuberculosis patients in Brazil |
| title_sort | incident mycobacterium tuberculosis infection in household contacts of infectious tuberculosis patients in brazil |
| topic | Household contact study M. tuberculosis infection TST conversion Brazil Latent tuberculosis infection |
| url | http://link.springer.com/article/10.1186/s12879-017-2675-3 |
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