TY - JOUR T1 - Tuberculosis in household contacts of multidrug-resistant tuberculosis patients JF - European Respiratory Journal JO - Eur Respir J VL - 38 IS - Suppl 55 SP - 1351 AU - Louis Grandjean AU - Aldo Crossa AU - Robert Gilman AU - David Moore Y1 - 2011/09/01 UR - http://erj.ersjournals.com/content/38/Suppl_55/1351.abstract N2 - Setting: The burden of tuberculosis disease amongst household contacts of multidrug-resistant tuberculosis patients is poorly understood and might represent a target for transmission-interrupting interventions.Design: This retrospective cohort study conducted in Lima from June to September 2008, estimated the incidence of tuberculosis disease among household contacts of multidrug-resistant tuberculosis patients in 358 households.Results: 108 (5%) of 2112 household contacts in 80 households (22% of households) developed tuberculosis disease during the study, equating to an incidence rate of 2360 per 100,000 contact follow-up years for each of the first 3 years after exposure. Drug susceptibility tests were available on 50 diseased contacts of whom 36 (80%) had multidrug-resistant tuberculosis. Forty-two pairs of index-contact drug susceptibility tests were available amongst which the contact had an identical or less resistant phenotype than the index case in 27 pairs. Multivariate clustered Cox regression demonstrated that contacts with a previous history of tuberculosis disease (Hazard Ratio 15.0, P<0.001) and with associated (non-HIV) comorbidities (Hazard Ratio 7.8, P<0.001) were significantly more likely to develop tuberculosis.Conclusion: The high percentage of diseased household contacts highlights an opportunity for household level interventions to prevent transmission, whether or not these subsequent cases were all attributable to the index case. ER -