Yield of contact investigations in households of patients with drug-resistant tuberculosis: Systematic review and meta-analysis

N. Sarita Shah, Courtney M. Yuen, Moonseong Heo, Arielle W. Tolman, Mercedes C. Becerra

Research output: Contribution to journalReview article

67 Scopus citations

Abstract

Contact investigations among individuals living with drug-susceptible tuberculosis patients (source cases) have shown a high yield of tuberculosis disease and latent tuberculosis, but the yield of such investigations in households of drug-resistant tuberculosis source cases is unknown. In this systematic review and meta-analysis, we found 25 studies that evaluated a median of 111 (interquartile range, 21-302) household contacts of drug-resistant tuberculosis source cases. The pooled yield was 7.8% (95% CI, 5.6%-10.0%) for active tuberculosis and 47.2% (95% CI, 30.0%-61.4%) for latent tuberculosis, although there was significant statistical heterogeneity (P <. 0001). More than 50% of secondary cases with drug susceptibility test results were concordant with those of the source case. Among studies that followed household members, the majority of secondary cases were detected within 1 year of the source case's diagnosis. Household contact investigation around drug-resistant tuberculosis patients is a high-yield intervention for detection of drug-resistant tuberculosis and prevention of ongoing transmission.

Original languageEnglish (US)
Pages (from-to)381-391
Number of pages11
JournalClinical Infectious Diseases
Volume58
Issue number3
DOIs
StatePublished - Feb 1 2014

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Keywords

  • contact
  • drug resistance
  • transmission
  • tuberculosis

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases

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