Missed opportunity for tuberculosis case detection in household contacts in a high burden setting

Contact investigation remains an essential component of tuberculosis (TB) control, yet missed opportunities to trace, medically examine, and treat close contacts of newly diagnosed index TB cases persist. We report a new case of active TB in a 21 year-old woman who was a household contact of a known TB index case in Kampala, Uganda. She was identified during a house-to-house TB case finding survey using chronic cough (≥2 weeks). This case study re-emphasizes two important public health issues in relation to TB control in developing countries; the need to promote active contact investigations by National TB programs and the potential complementary role of active case finding in minimizing delays in TB detection especially in high burden settings like Uganda.

[1]  J. Golub,et al.  Delay in diagnosis of pulmonary tuberculosis at a primary health clinic in Vitoria, Brazil. , 2010, The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease.

[2]  C. Whalen,et al.  Active case finding of undetected tuberculosis among chronic coughers in a slum setting in Kampala, Uganda. , 2009, The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease.

[3]  W. Boom,et al.  Immune correlates of acute Mycobacterium tuberculosis infection in household contacts in Kampala, Uganda. , 2006, The American journal of tropical medicine and hygiene.

[4]  M. Kiwuwa,et al.  Patient and health service delay in pulmonary tuberculosis patients attending a referral hospital: a cross-sectional study , 2005, BMC public health.

[5]  R. Chaisson,et al.  Active case finding of tuberculosis: historical perspective and future prospects. , 2005, The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease.

[6]  R. Horsburgh,et al.  Priorities for the treatment of latent tuberculosis infection in the United States. , 2004, The New England journal of medicine.

[7]  D. Guwatudde,et al.  Tuberculosis in household contacts of infectious cases in Kampala, Uganda. , 2003, American journal of epidemiology.

[8]  N. Qualls,et al.  Tuberculosis contact investigation policies, practices, and challenges in 11 U.S. communities. , 2002, Journal of public health management and practice : JPHMP.

[9]  Digambar Behera,et al.  Global tuberculosis control 2010 , 2012 .

[10]  G. Tillotson,et al.  Household contact investigation of tuberculosis in low- income and middle-income countries: public-health impact , 2009 .