Screening for tuberculosis among 2381 household contacts of sputum-smear-positive cases in The Gambia

2007

Article référencé dans le Web of Science WOS:000246834400012

Jackson Sillah D., Hill P. C., Fox A., Brookes R. H., Donkor S. A., Lugos M. D., Howie S. R. C., Fielding K. R., Jallow A., Lienhardt Christian, Corrah T., Adegbola R. A., McAdam K. P.

Transactions of the Royal Society of Tropical Medicine and Hygiene, 2007, 101 (6), p. 594-601 ISSN 0035-9203

Contact investigation is a key component of tuberculosis (TB) control in developed, but not developing, countries. We aimed to measure the prevalence of TB among household contacts of sputum-smear-positive TB cases in The Gambia and to assess the sensitivity of an enzyme-linked immunospot (ELISPOT) assay in this regard. Household contacts of adult smear-positive TB patients were assessed by questionnaire, purified protein derivative (PPD) skin test, ELISPOT assay, physical examination, chest X-ray and sputum/gastric aspirate. Thirty-three TB cases were identified from 2174 of 2381 contacts of 317 adult smear-positive pulmonary TB patients, giving a prevalence of 1518/100000. The cases identified tended to have milder disease than those passively detected. The sensitivity of ESAT-6/CFP-10 ELISPOT test as a screening test for TB disease was estimated as 71%. Fifty-six per cent of contacts with a PPD skin test result >= 10 mm induration had detectable responses to ESAT-6/CFP-10 by ELISPOT, 11% with a negative PPD skin test (<10 mm) had a positive ESAT-6/CFP-10 response. Active screening for TB among contacts of TB patients may have a role in TB control in The Gambia. These individuals are a high-risk group, and the disease identified is less advanced than that found through passive case detection. An ELISPOT assay was relatively insensitive as a screening test for TB.

Santé : généralités [050]

Fonds IRD [F B010040602]

fdi:010040602