Abstract
Introduction: Ethiopia is a high burden country for TB and MDR-TB. The case detection rate for all forms of TB in Ethiopia is at 62% well below the target rate of 90%. Although both WHO and Ethiopian guidelines suggest contact investigation for household contacts of index cases, this is not routinely done in the local setting due to lack of human and financial resources. Our aim was to early identify TB and MDR-TB cases among household contacts of patients with pulmonaryTB(PTB).
Methods: All patients diagnosed with smear positive or negative PTB at Asella Hospital were enrolled as index cases. Each household member was assessed for signs and symptoms of PTB and extraPTB. Sputum samples were collected and examined microscopically and with Xpert. Treatment according to national guidelines was started where required.
Results: 58 index cases were enrolled, 64% smear positive and 36% negative;3.4% were Rif-resistant(Xpert). 235 household members including 22 children <5y were screened. 9% underwent sputum investigation; 19% of them were diagnosed with active TB and started treatment. All screened children without signs or symptoms of TB but with close contact with an index cases were advised to start INH-preventive therapy as by national guidelines.
Conclusions: Through active contact tracing we diagnosed many(75%) cases of active TB in children<10y. Also, many children under the age of 5 were put on preventive TB-therapy, thus fulfilling a gap, as this procedure is not routinely done by local authorities in our settings. As expected, the use of Xpert turned out to be a very efficient and quick diagnostic tool, especially for detection of Rif resistance.
- Copyright ©the authors 2016
