Implementing contact tracing for tuberculosis in Kyrgyz Republic and risk factors for positivity using QuantiFERON-TB Go
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RESEARCH ARTICLE
Open Access
Implementing contact tracing for tuberculosis in Kyrgyz Republic and risk factors for positivity using QuantiFERON-TB Gold plus Caroline Corbett1*† , Aizat Kulzhabaeva2†, Tatjana Toichkina2†, Gulmira Kalmambetova3, Sevim Ahmedov4, Uladzimir Antonenka1, Altyn Iskakova3, Dilorom Kosimova5, Dasha Migunov5, Bakyt Myrzaliev6, Evgeni Sahalchyk1, Nagira Umetalieva1, Monica Vogel1†, Abdylat Kadyrov7 and Harald Hoffmann1,8†
Abstract Background: Effective active case finding (ACF) activities are essential for early identification of new cases of active tuberculosis (TB) and latent TB infection (LTBI). Accurate diagnostics as well as the ability to identify contacts at high risk of infection are essential for ACF, and have not been systematically reported from Central Asia. The objective was to implement a pilot ACF program to determine the prevalence and risk factors for LTBI and active TB among contacts of individuals with TB in Kyrgyz Republic using Quantiferon-TB Gold plus (QuantiFERON). Methods: An enhanced ACF project in the Kyrgyz Republic was implemented in which close and household (home) contacts of TB patients from the Issyk-Kul Oblast TB Center were visited at home. QuantiFERON and the tuberculin skin test (TST) alongside clinical and bacteriological examination were used to identify LTBI and active TB cases among contacts. The association for QuantiFERON positivity and risk factors were analysed and compared to TST results. Results: Implementation of ACF with QuantiFERON involved close collaboration with the national sanitary and epidemiological services (SES) and laboratories in the Kyrgyz Republic. From 67 index cases, 296 contacts were enrolled of whom 253 had QuantiFERON or TST results; of those 103 contacts had LTBI (positive TST or IGRA), and four (1.4%) active TB cases were detected. Index case smear microscopy (OR 1.76) and high household density (OR 1.97) were significant risk factors for QuantiFERON positivity for all contacts. When stratified by age, association with smear positivity disappeared for children below 15 years. TST was not associated with any risk factor. (Continued on next page)
* Correspondence: [email protected] † Caroline Corbett, Aizat Kulzhabaeva, Tatjana Toichkina, Monica Vogel and Harald Hoffmann contributed equally to this work. 1 Departments SYNLAB Gauting & IML red GmbH, WHO - Supranational Tuberculosis Reference Laboratory Munich-Gauting, Institute of Microbiology and Laboratory Medicine, Robert-Koch-Allee 2, D-82131 Gauting, Germany Full list of author information is available at the end of the article © The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are inclu
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