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dc.contributor.authorBekken, Gry Klouman
dc.contributor.authorRitz, Christian
dc.contributor.authorSelvam, Sumithra
dc.contributor.authorJesuraj, Nelson
dc.contributor.authorHesseling, Anneke
dc.contributor.authorDoherty, T. Mark
dc.contributor.authorGrewal, Harleen
dc.contributor.authorVaz, Mario
dc.contributor.authorJenum, Synne
dc.date.accessioned2021-06-30T13:24:45Z
dc.date.available2021-06-30T13:24:45Z
dc.date.created2020-09-22T12:01:08Z
dc.date.issued2020-01-31
dc.PublishedBMC Infectious Diseases. 2020, 20:96 1-11.
dc.identifier.issn1471-2334
dc.identifier.urihttps://hdl.handle.net/11250/2762613
dc.description.abstractBackground: The goal of tuberculosis elimination put forward in the End TB Strategy prioritizes diagnosis and treatment of incipient and subclinical TB, recently defined by key stakeholders as “asymptomatic, early pre-clinical disease during which pathology evolves”. Regarded as indicative of a high risk of TB progression, considerable efforts have been made to identify these cases through exploration of biomarkers. The present study aimed to evaluate simple scoring systems for TB exposure as screening tools for subclinical TB, the only identifiable of the incipient and subclinical disease states, in a contact investigation (CI) setting of low HIV-prevalence. Methods: Nested within a large prospective study in household contacts (HHCs) of smear positive pulmonary TB cases in South-India conducted 2010–2012, we assessed 1) the association between the Tuberculosis Contact Score (TCS) and the Infectivity Score, with established tools for Mycobacterium tuberculosis (Mtb) infection, corrected for established TB risk factors, and 2) the capability of the TB exposure scores to identify subclinical TB defined by Mtb-culture positivity in sputum or gastric aspirate (subjects < 5 years) specimen. Results: Of 525 HHCs, 29 were Mtb-culture positive and 96.6% of these asymptomatic. The TCS and the Infectivity Score associated with positive Tuberculin Skin Test and QuantiFeron TB-Gold In-tube assay (QFT) results in multivariate analyses (TCS: ORTST 1.16, 95% CI: 1.01, 1.33; ORQFT 1.33 95% CI: 1.16, 1.51. Infectivity Score: ORTST 1.39, 95% CI: 1.10, 1.76; ORQFT 1.41 95% CI: 1.16, 1.71). The Infectivity Score showed a moderate capability to identify subclinical TB (AUC of 0.61, 95% CI: 0.52, 0.70). Conclusions: Although our results did not identify an easily applicable screening tool for subclinical TB, the present study indicates that focusing on TB-related symptoms in CI settings may be of limited value for early identification of HHCs with high risk for TB progression.en_US
dc.language.isoengen_US
dc.publisherBioMed Centralen_US
dc.rightsNavngivelse 4.0 Internasjonal*
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/deed.no*
dc.titleIdentification of subclinical tuberculosis in household contacts using exposure scores and contact investigationsen_US
dc.typeJournal articleen_US
dc.typePeer revieweden_US
dc.description.versionpublishedVersionen_US
dc.rights.holderCopyright the authorsen_US
dc.source.articlenumber96en_US
cristin.ispublishedtrue
cristin.fulltextoriginal
cristin.qualitycode1
dc.identifier.doi10.1186/s12879-020-4800-y
dc.identifier.cristin1832048
dc.source.journalBMC Infectious Diseasesen_US
dc.source.4020:96
dc.identifier.citationBMC Infectious Diseases. 2020, 20, 96.en_US
dc.source.volume20en_US


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Navngivelse 4.0 Internasjonal
Except where otherwise noted, this item's license is described as Navngivelse 4.0 Internasjonal