%0 Journal Article
%9 ACL : Articles dans des revues avec comité de lecture répertoriées par l'AERES
%A Jackson Sillah, D.
%A Hill, P. C.
%A Fox, A.
%A Brookes, R. H.
%A Donkor, S. A.
%A Lugos, M. D.
%A Howie, S. R. C.
%A Fielding, K. R.
%A Jallow, A.
%A Lienhardt, Christian
%A Corrah, T.
%A Adegbola, R. A.
%A McAdam, K. P.
%T Screening for tuberculosis among 2381 household contacts of sputum-smear-positive cases in The Gambia
%D 2007
%L fdi:010040602
%G ENG
%J Transactions of the Royal Society of Tropical Medicine and Hygiene
%@ 0035-9203
%K tuberculosis ; Mycobacterium tuberculosis ; screening ; tuberculin skin test ; ELISPOT ; The Gambia
%M CC:0002468344-0012
%N 6
%P 594-601
%R 10.1016/j.trstmh.2007.02.001
%U https://www.documentation.ird.fr/hor/fdi:010040602
%> https://www.documentation.ird.fr/intranet/publi/2007/07/010040602.pdf
%V 101
%W Horizon (IRD)
%X 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.
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