%0 Journal Article
%9 ACL : Articles dans des revues avec comité de lecture répertoriées par l'AERES
%A Bonnet, Maryline
%A Kyakwera, C.
%A Kyomugasho, N.
%A Atwine, D.
%A Mugabe, F.
%A Nansumba, M.
%A Boum, Y.
%A Mwanga-Amumpaire, J.
%A Kiwanuka, J.
%T Prospective cohort study of the feasibility and yield of household child tuberculosis contact screening in Uganda
%D 2017
%L fdi:010070905
%G ENG
%J International Journal of Tuberculosis and Lung Disease
%@ 1027-3719
%K childhood tuberculosis ; symptom-based screening
%K OUGANDA
%M ISI:000406895600006
%N 8
%P 862-868
%R 10.5588/ijtld.16.0889
%U https://www.documentation.ird.fr/hor/fdi:010070905
%> https://www.documentation.ird.fr/intranet/publi/2017/09/010070905.pdf
%V 21
%W Horizon (IRD)
%X SETTING: Screening and isoniazid preventive therapy (IPT) of child contacts of tuberculosis (TB) patients is 'poorly implemented in resource-limited countries, in part due to difficulties in TB diagnosis in children. OBJECTIVE: To assess the feasibility and yield of hospital-based screening and IPT in Uganda, and to evaluate the utility of symptom-based screening. DESIGN: Household child (age <5 years) contacts of adults with pulmonary TB were assessed for TB or latent tuberculous infection (LTBI). Children classified as 'LTBI' or 'uninfected' were prescribed IPT and followed for 9 months. Screening algorithms based on combinations of symptoms associated with TB were constructed post hoc, and their performance evaluated against a radiological-based reference standard. RESULTS: Of 281 contacts (median age 33 months), 44 (15.7%) started anti-tuberculosis treatment and 234 (83.3%) received IPT, 80.3% of whom completed a 6 month course. After adjustment for age and human immunodeficiency virus status, cough (aOR 4.10, 95%CI 1.39-12.11) and reduced playfulness (aOR 7.79, 95%CI 2.12-25.18) were associated with radiological TB. Screening based on cough or reduced playfulness had a sensitivity of 81.8% and a negative predictive value of 97.6%. CONCLUSION: Hospital-based screening appears to be feasible, and confirms the potential utility of symptom based screening to select children for IPT and those for further investigations.
%$ 050